| NPI | 1902392525 |
|---|---|
| Other Name | ODAM MEDICAL GROUP - ST. CLOUD |
| Entity Type | Organization |
| Authorized Contact | ROBERT LARBI-ODAM CEO 612-871-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2023-07-23 |