Provider First Line Business Practice Location Address:
1900 CENTRACARE CIRCLE #2300
Provider Second Line Business Practice Location Address:
CENTRACARE CLINIC HEALTH PLAZA OBSTETRICS AND WOMENS HE
Provider Business Practice Location Address City Name:
ST CLOUD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56303-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-654-3630
Provider Business Practice Location Address Fax Number:
320-654-3657
Provider Enumeration Date:
11/04/2005