| NPI | 1538137757 |
|---|---|
| Other Name | SOUTHSIDE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANN CAZABAN Executive Director 612-821-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-12-10 |