NPI | 1407858020 |
---|---|
Doing Business As | CENTRACARE - PLAZA CLINIC |
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 | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MN 411086657) |
261QU0200X Clinic/Center, Urgent Care | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2005-08-12 |
Last Update Date | 2020-11-19 |