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Organization

SLEEP CENTER OF WILLMAR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARAD DOUGLAS RIPPERGER (MANAGER)
(320) 441-2104
Entity
Organization

Contact information

Practice address
2100 19TH AVE SW STE 1, WILLMAR, MN 56201-5287
(320) 441-2104
(320) 441-2052
Mailing address
2100 19TH AVE SW STE 1, WILLMAR, MN 56201-5287
(320) 441-2104
(320) 441-2052

Taxonomy

Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
6586527
MN
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6586527
MN LICENSE
NC
Enumeration date
04/09/2012
Last updated
04/03/2019
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