Provider First Line Business Practice Location Address:
3701 12TH STREET NORTH
Provider Second Line Business Practice Location Address:
MIDSOTA BEHAVIORAL HEALTH SUITE 206
Provider Business Practice Location Address City Name:
SAINT CLOUD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-229-4918
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2026