Central Lakes Medical Clinic PA

NPI #1881621761 in Crosby, Minnesota

Provider Information

NPI Number: 1881621761
Entity Type: Organization
Organization Name: Central Lakes Medical Clinic PA
Primary Specialty: Family Medicine
Enumeration Date: Jun 27, 2006
Last Updated: Oct 9, 2008

Practice Location

Address: 318 EAST MAIN STREET
City: Crosby
State: Minnesota
ZIP Code: 56441-1691
Phone: (218) 546-8375

Authorized Official

Name: JOHN D PETERSON
Title: CEO
Phone: (218) 546-2501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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