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General NPI Number Information
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NPI Number | 1871635706
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Entity Type | Organization
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Legal Business Name | FIRSTSOLUTIONS
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 1502 LONDON RD SUITE 102
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City | DULUTH
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State | MN
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Zip | 55812-1788
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Country | US
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Telephone | 218-727-8228
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Fax | 218-733-1325
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Provider Business Mailing Address
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Address Line | 1502 LONDON RD SUITE 102
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City | DULUTH
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State | MN
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Zip | 55812-1788
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Country | US
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Telephone | 218-727-8228
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Fax | 218-733-1325
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Authorized Official
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Title or Position | CEO
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Name | MR. TERRY R JACOBSON
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Credential |
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Telephone | 21874002330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 24D0404121
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License Number State | MN
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