Organization
CENTRAL MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO MORALES-UTRILLA M.D. (MEDICAL DIRECTOR)
(651) 644-6002
Entity
Organization
Contact information
Practice address
393 DUNLAP ST N, SUITE LL34, SAINT PAUL, MN 55104-4200
(651) 644-6002
Mailing address
393 DUNLAP ST N, SUITE LL34, SAINT PAUL, MN 55104-4200
(651) 644-6002
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
37899
MN
Other
Enumeration date
10/22/2012
Last updated
11/01/2013
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