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665 3rd St Sw Perham MN 56573-1199 | |
(218) 347-1200 | |
(218) 346-4043 |
Full Name | |
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Speciality | Family Medicine |
Location | 665 3rd St Sw, Perham, Minnesota |
Authorized Official Name and Position | Martha Leclerc (VICE PRESIDENT) |
Authorized Official Contact | 7012346248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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665 3rd St Sw Perham MN 56573-1199 Ph: (218) 347-1200 | 665 3rd St Sw Perham MN 56573-1199 Ph: (218) 347-1200 |
NPI Number | 1457631814 |
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Provider Enumeration Date | 08/17/2011 |
Last Update Date | 08/17/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457631814 | NPI | - | NPPES |
149715400 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |