Graduated: 1998
NPI: 1104885888
Practice Locations (2)
CENTRACARE CLINIC SOUTHWEST LLC
600 PETERSON PKWY
NEW LONDON, MN 562737823
3203542222
CENTRACARE CLINIC SOUTHWEST LLC
101 WILLMAR AVE SW
WILLMAR, MN 562013556
3202315000
Source: CMS National Downloadable File, September 2026.