Organization
INNOVIS HEALTH LLC
Active
Parent organization
ESSENTIA HEALTH MBR
Other names
Essentia Health-Detroit Lakes/Hwy 10 Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH MBR
Authorized official
ALAN J HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
1361 WENNER RD, DETROIT LAKES, MN 56501-7918
(218) 846-9981
Mailing address
PO BOX 1450 NW7813, MINNEAPOLIS, MN 55485-7813
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/26/2016
Last updated
10/01/2021
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