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Organization

SELAH WELLNESS CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TINA KELLER (VP COMPLIANCE)
(320) 372-2323
Entity
Organization

Contact information

Practice address
1300 NORTHRIDGE CT NW, PINE CITY, MN 55063-5821
(320) 372-2323
Mailing address
501 MAIN ST, SANDSTONE, MN 55072-4410
(320) 372-2323

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
04/19/2023
Last updated
01/04/2026
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