| NPI | 1700281953 |
|---|---|
| Doing Business As | CENTRACARE CLINIC- ADULT & PEDIATRIC UROLOGY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BLAIR Sr VP & CFO 320-255-5665 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2020-11-19 |