| Organization Name: | INNOVIS HEALTH, LLC |
| NPI Number: | 1225214133 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY C GLASNER (CEO) |
| Mailing Address: | 125 Frazee St E Detroit Lakes |
| State: | MN US |
| Postal Code: | 565013501 |
| Phone Number: | 2182442300 |
| Fax Number: | 2188442444 |
| NPI Enumeration Date: | 01/10/2008 |
| NPI Last Update Date: | 11/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |