NPI | 1225030844 |
---|---|
Doing Business As | CENTRACARE - PLAZA CLINIC (WOMEN & CHILDREN) |
Entity Type | Organization |
Authorized Contact | MICHAEL A BLAIR Sr VP & CFO 320-255-5665 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2005-08-12 |
Last Update Date | 2022-07-21 |