MEDICARE: INNOVIS HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1750725743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVIS HEALTH LLC

Provider Business Mailing Address
First Line	:	501 MAIN AVE S
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-4108
Country	:	US
Telephone Number	:	701-242-7118
Fax Number	:	701-671-4153

Provider Business Practice Location Address
First Line	:	501 MAIN AVE S
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-4108
Country	:	US
Telephone Number	:	701-242-7118
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ALAN HURLEY
Credential	:
Telephone Number	:	701-364-7667

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	03/01/2024

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Directions to “INNOVIS HEALTH LLC ” Practice Location

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