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401 12th St N Wheaton MN 56296-1070 | |
(320) 563-8971 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 401 12th St N, Wheaton, Minnesota |
Authorized Official Name and Position | Martha K 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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401 12th St N Wheaton MN 56296-1070 Ph: (320) 563-8971 | 401 12th St N Wheaton MN 56296-1070 Ph: (320) 563-8971 |
NPI Number | 1760737670 |
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Provider Enumeration Date | 07/17/2012 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
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1760737670 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |