Organization
FARGO HEALTH, INC.
Active
Other names
MN Spine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ERIC HANSON (PRESIDENT)
(612) 432-4131
Entity
Organization
Contact information
Practice address
9325 UPLAND LN N, SUITE 205, MAPLE GROVE, MN 55369-4200
(612) 670-4971
Mailing address
PO BOX 430, ISANTI, MN 55040-0430
(612) 432-4131
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/02/2016
Last updated
01/06/2018
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