| NPI | 1982919395 |
|---|---|
| Doing Business As | WILLIAMS/INTEGRACARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARK RANDY HALSTROM Medical Director 320-251-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 1491) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 1491) |
| 363L00000X Nurse Practitioner (Licence: MN 1491) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2019-01-24 |