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General NPI Number Information
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NPI Number | 1891553954
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Entity Type | Organization
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Legal Business Name | DSI HOLDING CORPORATION
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 3205 MIKE COLLINS DR
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City | EAGAN
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State | MN
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Zip | 55121-2241
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Country | US
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Telephone | 651-755-8735
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 WISCONSIN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4019
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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 | BUSINESS DEVELOPMENT MANAGER
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Name | MAURICE WILHELM
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Credential |
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Telephone | 651-755-8735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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