Luistro, Allan James

Luistro, Allan James is an sole proprietor health care provider with primary practice located at 1104 7Th Ave S. Box 92 Msum Hendrix Clinic & Counseling Center, Moorhead MN 56563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Luistro, Allan James can be contacted via phone (218) 477-2211.

Contact Information

Primary practice address
1104 7Th Ave S. Box 92 Msum Hendrix Clinic & Counseling Center Moorhead MN 56563
Phone: (218) 477-2211
Fax: (218) 477-5867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37656 Minnesota

Profile Details

NPI number 1073648259
LBN Legal business name Luistro, Allan James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2007
Last updated Feb 22nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073648259 NPPES
Minnesota MEDICAID 804733200
Minnesota MEDICAID 17256

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