Organization
CENTRACARE CLINIC SOUTHWEST LLC
Active
Organization
CENTRACARE CLINIC SOUTHWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BLAIR (CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
04/18/2022
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