| |
405 W 3rd Ave N Box 392 Aurora MN 55705-1247 | |
(218) 229-3311 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 405 W 3rd Ave N, Aurora, Minnesota |
Authorized Official Name and Position | Michael Metcalf (EX. VP & SR. OFFICER DC OPERATIONS) |
Authorized Official Contact | 2187862625 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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405 W 3rd Ave N Box 392 Aurora MN 55705-1247 Ph: (218) 229-3311 | 405 W 3rd Ave N Box 392 Aurora MN 55705-1247 Ph: (218) 229-3311 |
NPI Number | 1982641791 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 02/11/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982641791 | NPI | - | NPPES |
230814200 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |