Graduated: 1992
NPI: 1154860740
Practice Locations (4)
CENTRACARE CLINIC
1200 6TH AVE N, CENTRACARE CLIC RIVER CAMPUS
SAINT CLOUD, MN 563032735
3202525131
ST CLOUD HOSPITAL
1406 6TH AVE N
SAINT CLOUD, MN 563031900
3202512700
ST CLOUD HOSPITAL
1564 CTY RD, SUITE 134
ST CLOUD, MN 563030346
3202294950
ST CLOUD HOSPITAL
110 2ND ST S, SUITE 104
WAITE PARK, MN 563871367
3202599375
Source: CMS National Downloadable File, September 2026.