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General NPI Number Information
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NPI Number | 1215106893
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Entity Type | Organization
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Legal Business Name | CLEARCORPS USA
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 1522 ALBANY AVE
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City | SAINT PAUL
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State | MN
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Zip | 55108-2505
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Country | US
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Telephone | 651-603-8000
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Fax | 651-603-8006
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Provider Business Mailing Address
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Address Line | 1522 ALBANY AVE
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City | SAINT PAUL
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State | MN
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Zip | 55108-2505
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Country | US
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Telephone | 651-603-8000
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Fax | 651-603-8006
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SUE GUNDERSON
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Credential |
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Telephone | 651-603-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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