Southside Community Health Services, Inc.

NPI #1578680872 in Stillwater, Minnesota

Provider Information

NPI Number
1578680872
Entity Type
Organization
Organization Name
Southside Community Health Services, Inc.
Primary Specialty
Family Medicine
Enumeration Date
Mar 23, 2007
Last Updated
Apr 30, 2014

Practice Location

Address
5640 MEMORIAL AVE N
Address 2
SUITE B
ZIP Code
55082-2166
Phone
(651) 430-1880

Authorized Official

Name
WILLIAM HENRY TENDLE JR.
Title
EXECUTIVE DIRECTOR
Phone
(612) 821-2800

Specialties & Taxonomy Codes

Specialty
Family Medicine

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