Organization
CHRIS JENSEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALYA NEKTALOV OTR/L (OCCUPATIONAL THERAPIST/L)
(218) 625-6444
Entity
Organization
Contact information
Practice address
2501 RICE LAKE RD, DULUTH, MN 55811-4819
(218) 625-6444
Mailing address
2501 RICE LAKE RD, DULUTH, MN 55811-4819
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
104229
MN
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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