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Organization

KETAMINE NORTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATALIE NICOLE JOHNSON CRNA (OWNER)
(507) 398-6313
Entity
Organization

Contact information

Practice address
1003 E CENTRAL ENTRANCE, DULUTH, MN 55811-5501
(218) 209-2150
Mailing address
1003 E CENTRAL ENTRANCE, DULUTH, MN 55811-5501
(218) 209-2150

Taxonomy

Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary

Other

Enumeration date
07/28/2020
Last updated
07/28/2020
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