Organization
NORTH CENTRAL PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE NYBERG HANSON M.D. (DOCTOR)
(320) 253-6554
Entity
Organization
Contact information
Practice address
3701 12TH ST N, SUITE 201, SAINT CLOUD, MN 56303-2255
(320) 253-6554
(320) 253-1218
Mailing address
3701 12TH ST N, SUITE 201, SAINT CLOUD, MN 56303-2255
(320) 253-6554
(320) 253-1218
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
37636
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
729565100
—
MN
Enumeration date
06/02/2006
Last updated
10/14/2013
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