| Advanced Integrative Medicine | |
|
5 W Main St Crosby MN 56441-1421 | |
| (218) 546-7333 | |
| (218) 546-7334 |
| Full Name | Advanced Integrative Medicine |
|---|---|
| Speciality | General Practice |
| Location | 5 W Main St, Crosby, Minnesota |
| Authorized Official Name and Position | Mark Bostrom (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Contact | 2185467333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Integrative Medicine 5 W Main St Crosby MN 56441-1421 Ph: (218) 546-7333 | Advanced Integrative Medicine 5 W Main St Crosby MN 56441-1421 Ph: (218) 546-7333 |
| NPI Number | 1487949897 |
|---|---|
| Provider Enumeration Date | 06/14/2011 |
| Last Update Date | 10/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487949897 | NPI | - | NPPES |
| 85419100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 38115 (Minnesota) | Primary |
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