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Organization

COUNTRYSIDE MEDICAL CLINIC P.L.L.C

Active
Other names
CountrySide Medical Clinic P.L.L.C, CountrySide IV Lounge and Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
WYATT C. HAUGEN CWCA-BC, CSWS-BC (CLINIC OWNER)
(320) 226-5416
Entity
Organization

Contact information

Practice address
416 N 1ST ST STE 2, MONTEVIDEO, MN 56265-1408
(320) 226-5416
Mailing address
PO BOX 27, MONTEVIDEO, MN 56265-0027
(320) 226-5416

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QI0500X
Infusion Therapy Clinic/Center

Other

Enumeration date
06/03/2025
Last updated
10/10/2025
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