Healthcare Provider Details

I. General information

NPI: 1740416866
Provider Name (Legal Business Name): WATONWAN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 7TH AVE S
SAINT JAMES MN
56081-2439
US

IV. Provider business mailing address

1304 7TH AVE S
SAINT JAMES MN
56081-2439
US

V. Phone/Fax

Practice location:
  • Phone: 507-375-7385
  • Fax: 507-375-1301
Mailing address:
  • Phone: 507-375-7385
  • Fax: 507-375-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MS. MARJORIE R SMITH
Title or Position: PUBLIC TRANSIT DIRECTOR
Credential:
Phone: 507-375-7385