Organization
VICKI LYNN ROFF
Active
Other names
Northwest C&TC Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PARKIN M.D. (MEDICAL DIRECTOR)
(218) 333-5000
Entity
Organization
Contact information
Practice address
1231 5TH STREET NW, BEMIDJI, MN 56601
(218) 751-3196
(218) 759-1171
Mailing address
6248 BALSAM RD NW, BEMIDJI, MN 56601-7728
(218) 751-0674
(218) 759-1715
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
R 124141-5
MN
Other
Enumeration date
03/04/2010
Last updated
03/16/2010
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