Provider First Line Business Practice Location Address:
2000 23RD STREET SOUTH
Provider Second Line Business Practice Location Address:
CENTRACARE CLINIC SAUK CROSSING
Provider Business Practice Location Address City Name:
SARTELL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56377-4765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-229-5120
Provider Business Practice Location Address Fax Number:
320-200-3235
Provider Enumeration Date:
11/14/2006