Organization
PRIMAL INFUSIONS AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAKYLA ANN WENDROTH RN, BSN (OWNER)
(641) 691-8874
Entity
Organization
Contact information
Practice address
10455 165TH AVE SE, BECKER, MN 55308-4110
(641) 691-8874
Mailing address
10455 165TH AVE SE, BECKER, MN 55308-4110
(641) 691-8874
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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