Individual
MICHELLE LYNN LOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1555 NORTHWAY DR, SAINT CLOUD, MN 56303-4555
(320) 259-4100
(320) 257-5523
Mailing address
1555 NORTHWAY DR, SAINT CLOUD, MN 56303-4555
(320) 259-4100
(320) 257-5523
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10612
MN
Other
Enumeration date
07/18/2006
Last updated
09/15/2009
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