Organization
CENTRACARE CLINIC
Active
Other names
CentraCare Neurosciences Headache Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
2001 STOCKINGER DR STE 101, SAINT CLOUD, MN 56303-1243
(320) 534-3096
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 229-4977
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
01/11/2017
Last updated
06/23/2025
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