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General NPI Number Information
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NPI Number | 1245969179
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Entity Type | Organization
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Legal Business Name | NORTHERN MEDICAL STRATEGIES LLC
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 4316 RICE LAKE RD STE 104
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City | DULUTH
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State | MN
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Zip | 55811-2885
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Country | US
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Telephone | 701-318-2986
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Fax |
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Provider Business Mailing Address
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Address Line | 4316 RICE LAKE RD STE 104
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City | DULUTH
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State | MN
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Zip | 55811-2885
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BENJAMIN FAGERLIE
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Credential |
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Telephone | 701-318-2986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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