| Minnesota Integrative Medicine | |
|
7818 Excelsior Rd # 200 Baxter MN 56425-8427 | |
| (218) 454-9355 | |
| (218) 454-9356 |
| Full Name | Minnesota Integrative Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 7818 Excelsior Rd # 200, Baxter, Minnesota |
| Authorized Official Name and Position | Kasi Zack (OWNER) |
| Authorized Official Contact | 3204295566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Integrative Medicine 7818 Excelsior Rd # 200 Baxter MN 56425-8427 Ph: (218) 454-9355 | Minnesota Integrative Medicine 7818 Excelsior Rd # 200 Baxter MN 56425-8427 Ph: (218) 454-9355 |
| NPI Number | 1811664220 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 05/23/2022 |
| Medicare PECOS PAC ID | 2769874528 |
|---|---|
| Medicare Enrollment ID | O20220128000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811664220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Bachorik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083870646 PECOS PAC ID: 3971660820 Enrollment ID: I20111031000375 |
| Provider Name | Kasi Zack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740888536 PECOS PAC ID: 3678965431 Enrollment ID: I20220128000300 |
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