Prairie St. John's Clinic

NPI 1073601258 - Clinic/Center - 261QM0855X

NPI Details
NPI 1073601258
Enumeration Date 10/11/2006
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JERRY W JERRY
Position CHIEF FINANCIAL OFFICER
Phone (651) 259-9700
Fax (651) 259-9740
Practice Location
7616 CURRELL BLVD
SUITE 100
WOODBURY MN, 55125-2290, US
Phone (651) 259-9700
Fax (651) 259-9740
Business Location
510 4TH ST S
PO BOX 2027
FARGO ND, 58103-1914, US
Phone (701) 476-7221
Fax (701) 476-7261
Toxanomy
Taxonomy Code 261QM0855X
License State North Dakota
License Number 5063A
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According to our database, Prairie St. John's Clinic NPI is 1073601258, taxonomy code is 261QM0855X and license number is 5063A, license state is located at North Dakota. Prairie St. John's Clinic physically located at 7616 Currell Blvd, Woodbury MN, 55125-2290. NPI Number 1033115704 has the healthcare provider type.

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1073601258 NPI number is provided on an as is basis without warranty of any kind. 1073601258 is maintained by the National Plan & Provider Enumeration System. The contents of Prairie St. John's Clinic are for informational purposes only.