Provider Demographics
NPI:1033262845
Name:ROBERT J TORGRIMSON PA
Entity Type:Organization
Organization Name:ROBERT J TORGRIMSON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TORGRIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC D AB CO
Authorized Official - Phone:218-728-3686
Mailing Address - Street 1:1320 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-2342
Mailing Address - Country:US
Mailing Address - Phone:218-728-3686
Mailing Address - Fax:218-728-2996
Practice Address - Street 1:1320 KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-2342
Practice Address - Country:US
Practice Address - Phone:218-728-3686
Practice Address - Fax:218-728-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN930527100Medicaid
T66228Medicare UPIN
MN930527100Medicaid