# OCCUPATIONAL MEDICINE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609134832
- **Authorized official:** DAVID MICHAEL VAN NOSTRAND MD (OWNER)
- **Authorized official phone:** (320) 251-3666

## Contact information

- **Practice address:** 325 33RD AVE N, SUITE 110, SAINT CLOUD, MN 56303-3041
- **Practice address phone:** (320) 251-3666
- **Mailing address:** 325 33RD AVE N, SUITE 110, SAINT CLOUD, MN 56303-3041
- **Mailing address phone:** (320) 251-3666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 16374 | MN | Yes |

## Other

- **Enumeration date:** 04/25/2012
- **Last updated:** 04/25/2012