NPI | 1538137757 |
---|---|
Other Name | SOUTHSIDE MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | ANN CAZABAN Executive Director 612-821-2025 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-03-14 |
Last Update Date | 2023-07-10 |