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General NPI Number Information
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NPI Number | 1245052554
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Entity Type | Organization
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Legal Business Name | SMALL HOLDINGS PA
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 161 19TH ST S STE 106
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City | SARTELL
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State | MN
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Zip | 56377-2555
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Country | US
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Telephone | 320-252-3376
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Fax | 320-288-2701
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Provider Business Mailing Address
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Address Line | 161 19TH ST S STE 106
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City | SARTELL
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State | MN
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Zip | 56377-2555
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Country | US
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Telephone | 320-252-3376
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Fax | 320-288-2701
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. BARRY ALLEN LABINE
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Credential | MD
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Telephone | 320-217-3099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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