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General NPI Number Information
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NPI Number | 1942434378
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Entity Type | Organization
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Legal Business Name | THE DULUTH CLINIC, LTD
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 2101 BEASER AVE SUITE 1
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City | ASHLAND
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State | WI
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Zip | 54806-3638
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Country | US
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Telephone | 715-682-8183
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 BEASER AVE SUITE 1
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City | ASHLAND
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State | WI
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Zip | 54806-3638
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Country | US
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Telephone | 715-682-8183
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Fax |
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Authorized Official
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Title or Position | EVP
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Name | MICHAEL C METCALF
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Credential |
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Telephone | 218-786-2642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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