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Individual

LOLA B SUTHERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
16830 198TH AVE NW, BIG LAKE CLINIC, BIG LAKE, MN 55309
(763) 263-7300
Mailing address
1200 SIXTH AVE NO, CENTRA CARE CLINIC, SAINT CLOUD, MN 56303
(763) 263-7300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26313
MN
207Q00000X
Family Medicine Physician
Primary
MN26313
MN

Other

Enumeration date
03/03/2006
Last updated
12/05/2007
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