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 |