| NPI | 1164978219 |
|---|---|
| Doing Business As | CENTRACARE - MIDSOTA PLASTIC SURGERY |
| Doing Business As | MIDSOTA PLASTIC & RECONSTRUCTIVE SURGEONS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BLAIR Sr VP & CFO 320-255-5665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2020-11-19 |