Doctor Name: | MRS. WILMA RAE GIRTZ |
NPI Number: | 1245544881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 10369781CFC |
Business Practice Address: | 13508 190th St Park Rapids, MN - 564703295 |
Business Phone Number: | 2187325959 |
Business Fax Number: | |
Mailing Address: | 13508 190th St, PARK RAPIDS |
State: | MN |
Postal Code: | 564703295 |
Phone Number: | 2187325959 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2010 |
NPI Last Update Date: | 08/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 10369781CFC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |