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Organization

EPICENTERPHD INC

Active
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Organization

EPICENTERPHD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS WALTER MARTINI (CEO)
(612) 203-2473
Entity
Organization

Contact information

Practice address
8899 DEER VALLEY RD, PINE CITY, MN 55063-4424
(612) 203-2473
(612) 460-9804
Mailing address
8899 DEER VALLEY RD, PINE CITY, MN 55063-4424
(612) 203-2473
(612) 460-9804

Taxonomy

Speciality
Code
Description
License number
State
225XH1300X
Human Factors Occupational Therapist
380825
MN
253Z00000X
In Home Supportive Care Agency
Primary
380825
MN
302R00000X
Health Maintenance Organization
380825
MN
332B00000X
Durable Medical Equipment & Medical Supplies
380825
MN

Other

Enumeration date
03/22/2017
Last updated
03/22/2017
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