Graduated: 2003
NPI: 1568753606
Practice Locations (2)
MILLE LACS HEALTH SYSTEM
200 ELM ST N
ONAMIA, MN 563597901
3205323154
CENTRACARE CLINIC
1200 6TH N AVE
SAINT CLOUD, MN 563032735
3202525131
Source: CMS National Downloadable File, September 2026.