Individual
CLYDE RICHARD STEPHENS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
711 DELMORE DR, ROSEAU, MN 56751-1534
(218) 463-1365
Mailing address
235 OLD HIGHWAY 11 E, GREENBUSH, MN 56726-4128
(218) 782-2881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9532
MN
Other
Enumeration date
06/01/2006
Last updated
07/08/2007
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