Provider First Line Business Practice Location Address:
1900 CENTRACARE CIR #1300
Provider Second Line Business Practice Location Address:
CENTRACARE CLINIC - WOMEN'S AND CHILDRENS
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:
320-654-3610
Provider Business Practice Location Address Fax Number:
651-702-5305
Provider Enumeration Date:
02/28/2006