LIBERTY HEALTH PLLC NPI 1093471484

NPI Information

  • NPI: 1093471484
  • Provider Name: LIBERTY HEALTH PLLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • CLIA Number: 24D2247723
  • Address: 1361 WENNER RD
    DETROIT LAKES, MN
    ZIP 56501
  • Phone: (218) 396-6500

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NPI Details

LIBERTY HEALTH PLLC is a multi-specialty clinic center in Detroit Lakes, MN. LIBERTY HEALTH PLLC NPI is 1093471484. The provider is registered as an organization entity type.

The provider's business location address is:

1361 WENNER RD
DETROIT LAKES, MN
ZIP 56501-918
Phone: (218) 396-6500

The provider's authorized official is Scott Allen Lawrence .
The authorized official title is Clinical Director and has the following contact phone number (218) 779-7005.

The CLIA number assigned to this NPI record is 24D2247723 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/10/2021 and was last updated on 11/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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