Itasca Surgical Clinic, PA
NPI #1245288984 in Grand Rapids, Minnesota
Provider Information
- NPI Number
- 1245288984
- Entity Type
- Organization
- Organization Name
- Itasca Surgical Clinic, PA
- Primary Specialty
- Specialist
- Enumeration Date
- May 5, 2006
- Last Updated
- Jul 9, 2009
Practice Location
- Address
- 1542 GOLF COURSE RD
- Address 2
- SUITE 202
- City
- Grand Rapids
- State
- Minnesota
- ZIP Code
- 55744-9603
- Phone
- (218) 327-7973
Authorized Official
- Name
- DR. DANIEL MARGO, M.D.
- Title
- OWNER
- Phone
- (218) 327-7973
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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