Central Medical Clinic, PLLC.
Physician Assistant, Medical in Saint Paul, MN. Organization (NPI-2).
NPI number1053704635
StatusActive
Last updated in NPPESMar 6, 2015
Details
- NPI
- 1053704635
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Medical Clinic, PLLC.
- Organization subpart
- No
- Enumeration date
- Mar 6, 2015
- Last updated
- Mar 6, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 1123204 | MN | Yes |
Practice location
393 Dunlap St NLl34
Saint Paul, MN 55104-4200
Phone 651-644-6002 · Fax 651-647-1647
Mailing address
393 Dunlap St NLl34
Saint Paul, MN 55104-4200
Phone 651-644-6002 · Fax 651-647-1647
Authorized official
Christine Morales
Clinic Director
6516446002
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