Organization
LIGHT MOUNTAIN HEALTHWORKS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET ANN LISTEBARGER RN, MT (PRESIDENT)
(218) 759-0835
Entity
Organization
Contact information
Practice address
502 HIDDEN TRAIL CT SW, BEMIDJI, MN 56601-2569
(218) 759-0835
(218) 759-0835
Mailing address
502 HIDDEN TRAIL CT SW, BEMIDJI, MN 56601-2569
(218) 759-0835
(218) 759-0835
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
R107370-6
MN
Other
Enumeration date
04/10/2011
Last updated
04/10/2011
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