Graduated: 2019
NPI: 1205481405
Practice Locations (3)
ST MARYS REGIONAL HEALTH CENTER
1027 WASHINGTON AVE
DETROIT LAKES, MN 565013409
2188475611
INNOVIS HEALTH LLC
720 MAIN AVE
MOORHEAD, MN 565602752
2183590399
INNOVIS HEALTH LLC
4110 51ST AVE S
FARGO, ND 581047776
7013643100
Source: CMS National Downloadable File, September 2026.