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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 | Joann Foltz (CEO) |
Authorized Official Contact | 3205638226 |
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 | 1922287127 |
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Provider Enumeration Date | 10/24/2007 |
Last Update Date | 07/06/2010 |
Identifier | Type | State | Issuer |
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1922287127 | NPI | - | NPPES |
187968000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 243435 (Minnesota) | Primary |