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Itasca Surgical Clinic, Pa
Specialist in Grand Rapids, Minnesota
NPI 1245288984

Itasca Surgical Clinic, Pa is a Specialist based in Hibbing, MN. Itasca Surgical Clinic, Pa practices in Grand Rapids, MN. The NPI Number for Itasca Surgical Clinic, Pa is 1245288984 and holds a License No. (Minnesota).

The current practice location address for Itasca Surgical Clinic, Pa is 1542 Golf Course Rd, Grand Rapids, MN and can be reached out via phone at 218-327-7973 and via fax at 218-327-3245.

Location: 1542 Golf Course Rd, Grand Rapids, MN, 55746-3675
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1245288984
Provider Name
Itasca Surgical Clinic, Pa
Credential
Provider Entity Type
Organization
Address
1542 Golf Course Rd, Grand Rapids, MN, 55746-3675
Phone Number
218-327-7973
Fax Number
218-327-3245
Provider Enumeration Date
05/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
448327800 05 MN
97B18IT 01 MN BCBS
institution
Provider Business Practice Location Address Details
Address
1542 Golf Course Rd
City
Grand Rapids
State
Minnesota
Zip
55744-9603
Phone Number
218-327-7973
Fax Number
218-327-3245
person
Provider Business Mailing Address Details
Address
1542 Golf Course Rd
City
Grand Rapids
State
Minnesota
Zip
55744-9603
Phone Number
218-327-7973
Fax Number
218-327-3245
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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