Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1579 | MN |
NPI | 1679649818 |
---|---|
Provider Name | Dr. Robert James Torgrimson |
First Address | Duluth, MN 55811 |
Second Address | Duluth, MN 55811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 29/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03039T0 | BCBS (01) | MN |
930527100 | (05) | MN |
T66228 | (02) |