Graduated: 2025
NPI: 1326932609
Practice Locations (2)
CENTRACARE CLINIC
1200 6TH N AVE
SAINT CLOUD, MN 563032735
3202525131
CENTRACARE CLINIC SOUTHWEST LLC
101 WILLMAR AVE SW
WILLMAR, MN 562013556
3202315000
Source: CMS National Downloadable File, September 2026.