Graduated: 2022
NPI: 1790429595
Practice Locations (2)
CENTRACARE CLINIC
1301 33RD ST S
ST CLOUD, MN 563019668
3202518181
ST CLOUD HOSPITAL
1555 NORTHWAY DR, 200 CENTRA CARE FAMILY HEALTH CENTER
ST CLOUD, MN 563034913
3202403157
Source: CMS National Downloadable File, September 2026.