| Liberty Health Pllc | |
|
1361 Wenner Rd Detroit Lakes MN 56501-7918 | |
| (218) 396-6500 | |
| Not Available |
| Full Name | Liberty Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1361 Wenner Rd, Detroit Lakes, Minnesota |
| Authorized Official Name and Position | Scott Allen Lawrence (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2187797005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Health Pllc 1361 Wenner Rd Detroit Lakes MN 56501-7918 Ph: (218) 396-6500 | Liberty Health Pllc 1361 Wenner Rd Detroit Lakes MN 56501-7918 Ph: (218) 396-6500 |
| NPI Number | 1093471484 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 11/10/2021 |
| Medicare PECOS PAC ID | 0042602112 |
|---|---|
| Medicare Enrollment ID | O20220121002406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093471484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Scott A Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407874076 PECOS PAC ID: 6709771140 Enrollment ID: I20050523001253 |
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