Organization
ST. MARY'S REGIONAL HEALTH CENTER
Active
Parent organization
ST. MARY'S REGIONAL HEALTH CENTER
Other names
Essentia Health St. Mary's - Frazee Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S REGIONAL HEALTH CENTER
Authorized official
TANNER GOODRICH (PRESIDENT)
(218) 847-5611
Entity
Organization
Contact information
Practice address
300 MAIN AVE E, FRAZEE, MN 56544
(218) 334-7255
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 334-7255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892442000
—
MN
Enumeration date
04/24/2013
Last updated
10/01/2021
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