| |
1000 Coney St W Perham MN 56573-2102 | |
(218) 347-1200 | |
(218) 346-4043 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 1000 Coney St W, Perham, Minnesota |
Authorized Official Name and Position | Martha K Leclerc (VP) |
Authorized Official Contact | 7012346248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1000 Coney St W Perham MN 56573-2102 Ph: (218) 347-1200 | 1000 Coney St W Perham MN 56573-2102 Ph: (218) 347-1200 |
NPI Number | 1982637385 |
---|---|
Provider Enumeration Date | 07/09/2006 |
Last Update Date | 03/28/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982637385 | NPI | - | NPPES |
149715400 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |