Organization
RISING PHOENIX NATURAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN P DI DIEGO ND (OWNER/PRACTITIONER)
(507) 412-1219
Entity
Organization
Contact information
Practice address
105 CENTER AVE N, MADELIA, MN 56062-1429
(507) 412-1219
Mailing address
47544 105TH ST, TRUMAN, MN 56088-2172
(520) 227-1505
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
08/17/2022
Last updated
08/17/2022
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