OrganizationActive
Advanced Integrative Medicine
NPI 1487949897 · General Practice Physician · Crosby, MN
Provider details
- NPI number
- 1487949897
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Bostrom, Executive Medical Director(218) 546-7333
- License
- 38115 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5 W Main St
Crosby, MN 56441-1421
Phone: (218) 546-7333
Fax: (218) 546-7334
Approximate (ZIP-level) locationGet directions
Mailing address
5 W Main St
Crosby, MN 56441-1421
Registry dates
- Enumerated
- 2011-06-14
- Last updated
- 2011-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.