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32021 County Road 24 Blvd. Cannon Falls MN 55009-5003 | |
(507) 263-6000 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 32021 County Road 24 Blvd., Cannon Falls, Minnesota |
Authorized Official Name and Position | Praveen Mekala (CHEIF FINANCIAL OFFICER) |
Authorized Official Contact | 5075946449 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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32021 County Road 24 Blvd. Cannon Falls MN 55009-5003 Ph: (507) 263-6000 | 32021 County Road 24 Blvd. Cannon Falls MN 55009-5003 Ph: (507) 263-6000 |
NPI Number | 1497281695 |
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Provider Enumeration Date | 05/08/2017 |
Last Update Date | 03/23/2021 |
Identifier | Type | State | Issuer |
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1497281695 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |