Organization
INNOVIS HEALTH, LLC.
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Lisbon Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
819 MAIN ST, LISBON, ND 58054-4244
(701) 683-4134
(701) 683-4094
Mailing address
PO BOX 1450 NW 7813, MINNEAPOLIS, MN 55485-7813
(701) 253-5300
(701) 253-5402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716483300
—
MN
Enumeration date
11/10/2007
Last updated
03/01/2024
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