Organization
BETWEEN THE BRIDGES HEALING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MISSY R NELSON (OFFICE MANAGER)
(507) 388-7488
Entity
Organization
Contact information
Practice address
45 TETON LN, MANKATO, MN 56001-4814
(507) 388-7488
(507) 388-5680
Mailing address
45 TETON LN, MANKATO, MN 56001-4814
(507) 388-7488
(507) 388-5680
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
37416
MN
207Q00000X
Family Medicine Physician
Primary
37416
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
560320000
—
MN
Enumeration date
11/03/2006
Last updated
04/06/2009
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