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
- City
- Stillwater
- State
- Minnesota
- 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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