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Organization
CENTRAL MEDICAL WELLNESS INC
Active
Organization
CENTRAL MEDICAL WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO MORALES-UTRILLA MD (MEDICAL DIRECTOR)
(612) 730-5196
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE STE 230, SAINT PAUL, MN 55114-1503
(651) 746-4412
(651) 647-1647
Mailing address
7595 CURRELL BLVD UNIT 25404, WOODBURY, MN 55125-2569
(651) 746-4412
(651) 647-1647
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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