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Organization

INTERNAL MEDICINE CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KURT EDWARD WALSTROM MD (OWNER)
(651) 485-4571
Entity
Organization

Contact information

Practice address
18811 ENFIELD AVE N, FOREST LAKE, MN 55025-9489
(651) 485-4571
Mailing address
18811 ENFIELD AVE N, FOREST LAKE, MN 55025-9489
(651) 485-4571

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
47816
MN

Other

Enumeration date
03/24/2011
Last updated
03/29/2011
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