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General NPI Number Information
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NPI Number | 1720162787
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Entity Type | Organization
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Legal Business Name | STARBUCK CLINIC PLLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 POLER ST
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City | STARBUCK
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State | MN
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Zip | 56381
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Country | US
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Telephone | 320-239-3939
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Fax | 320-239-2802
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | STARBUCK
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State | MN
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Zip | 56381
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Country | US
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Telephone | 320-239-3939
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Fax | 320-239-2802
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Authorized Official
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Title or Position | CERTIFIED PROFESSIONAL CODER BILLER
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Name | STEPHANI BLEHR
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Credential | CPC
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Telephone | 320-239-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MN
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