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2025 Stearns Way Ste 114 Saint Cloud MN 56303 | |
| (320) 255-7195 | |
| (320) 200-3245 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2025 Stearns Way Ste 114, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Michael A Blair (SR VP & CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 6th Ave N Saint Cloud MN 56303-2735 Ph: (320) 252-5131 | 2025 Stearns Way Ste 114 Saint Cloud MN 56303 Ph: (320) 255-7195 |
| NPI Number | 1003339789 |
|---|---|
| Provider Enumeration Date | 07/25/2017 |
| Last Update Date | 11/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003339789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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