Provider Demographics
NPI:1649487240
Name:SISTER ROSALIND GEFRE SCHOOLS & CLINIC OF MASSAGE
Entity type:Organization
Organization Name:SISTER ROSALIND GEFRE SCHOOLS & CLINIC OF MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALISTS
Authorized Official - Prefix:MS
Authorized Official - First Name:JACINDA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-554-3013
Mailing Address - Street 1:149 THOMPSON AVE E
Mailing Address - Street 2:STE 160
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3238
Mailing Address - Country:US
Mailing Address - Phone:651-554-3013
Mailing Address - Fax:651-554-7608
Practice Address - Street 1:2145 FORD PARKWAY
Practice Address - Street 2:STE 20
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116
Practice Address - Country:US
Practice Address - Phone:651-698-9123
Practice Address - Fax:651-698-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN40F41SIOtherBLUE CROSS BLUE SHIELD