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Organization

SOUTH

Active
Other names
Fairmont ASC
Organization subpart
No

Provider details

NPI number
Authorized official
COREY T WELCHLIN DO (OWNER PRESIDENT)
(507) 238-4949
Entity
Organization

Contact information

Practice address
717 S STATE ST, STE 1000, FAIRMONT, MN 56031-4469
(507) 235-3939
Mailing address
717 S STATE ST, STE 900, FAIRMONT, MN 56031-4469

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
05/17/2016
Last updated
10/16/2023
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