St Cloud Medical Group PA
NPI #1487690996 in Saint Cloud, Minnesota
Provider Information
- NPI Number
- 1487690996
- Entity Type
- Organization
- Organization Name
- St Cloud Medical Group PA
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Jun 22, 2006
- Last Updated
- Oct 6, 2011
Practice Location
- Address
- 251 COUNTY ROAD 120
- City
- Saint Cloud
- State
- Minnesota
- ZIP Code
- 56303-4872
- Phone
- (320) 202-8949
Authorized Official
- Name
- CHRISTOPHER TACL, MD
- Title
- MEDICAL DIRECTOR
- Phone
- (320) 202-8949
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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