St. Cloud Ear, Nose & Throat - Surgical Suites LLC
NPI #1417188830 in Saint Cloud, Minnesota
Provider Information
- NPI Number
- 1417188830
- Entity Type
- Organization
- Organization Name
- St. Cloud Ear, Nose & Throat - Surgical Suites LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Aug 3, 2009
- Last Updated
- Aug 3, 2009
Practice Location
- Address
- 1528 NORTHWAY DR
- City
- Saint Cloud
- State
- Minnesota
- ZIP Code
- 56303-1255
- Phone
- (320) 252-0233
Authorized Official
- Name
- MR. LARRY R BOLLER, RRT, MBA
- Title
- ADMINISTRATOR
- Phone
- (320) 252-0233
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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