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Individual

MR. CHARLES EDWARD MCCALIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
50807 COUNTY 3, BEMIDJI, MN 56601-9616
(218) 751-2711
Mailing address
50807 COUNTY 3, BEMIDJI, MN 56601-9616
(218) 751-2711

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
214201-2-AFC
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
722222000
ADULT FOSTER CARE LICENSE
MN
Enumeration date
06/08/2008
Last updated
06/08/2008
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