Organization
PERHAM HOSPITAL DISTRICT
Active
Other names
Perham Health Ottertail Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
105 OTTER DR, OTTERTAIL, MN 56571-7040
(218) 367-6111
(218) 367-6110
Mailing address
105 OTTER DR, PO BOX 278, OTTERTAIL, MN 56571-7040
(218) 367-6111
(218) 367-6110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44100700
—
MN
Enumeration date
08/05/2011
Last updated
08/05/2011
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