Organization
LICE LOUNGE DULUTH, LLC
Active
Other names
Lice Lounge Duluth
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY RHEA MERRIMAN (OWNER, COO)
(651) 815-3644
Entity
Organization
Contact information
Practice address
113 N 2ND AVE W, DULUTH, MN 55802-1911
(218) 382-5423
Mailing address
2335 GASTON AVE, WHITE BEAR TOWNSHIP, MN 55110-2338
(651) 815-3644
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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