Organization
INNOVIS HEALTH, LLC
Active
Organization
INNOVIS HEALTH, LLC
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health 45th Street Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
4476 31ST AVE S STE 101, FARGO, ND 58104-4532
(701) 234-9400
(701) 234-9401
Mailing address
4476 31ST AVE S STE 101, FARGO, ND 58104-4532
(701) 234-9400
(701) 234-9401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
03/01/2024
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