Divine Providence Medical Clinic

NPI #1972660488 in Ivanhoe, Minnesota

Provider Information

NPI Number: 1972660488
Entity Type: Organization
Organization Name: Divine Providence Medical Clinic
Primary Specialty: Clinic/Center - Critical Access Hospital
Enumeration Date: Jan 3, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 312 E GEORGE ST
City: Ivanhoe
State: Minnesota
ZIP Code: 56142-9707
Phone: (507) 694-1414

Authorized Official

Name: MR. GREGORY WILSON
Title: CEO
Phone: (507) 694-1414

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Critical Access Hospital — Critical Access Hospital	261QC0050X	Primary

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