NPI Provider: 1558366146
Contact Name: Rikimoto Chere
Position: Administrator
Phone: (320) 563-8124
Traverse Care Center Information:
Traverse Care Center organization have npi 1558366146, taxonomy code is 314000000X with license number is 669 in . This Business address located in 303 7th St S, Wheaton, MN 56296 Minnesota.
Practice Location
Address: 303 7th St S, Wheaton, MN 56296
Phone: (320) 563-8124
Business Location
Address: 303 7th St S, Wheaton, MN 56296
Phone: (320) 563-8124
Fax: (320) 563-4133
Taxonomy
Taxonomy Code: 314000000X
License Number: 669
License Number of State: MN
Primary Taxonomy Switch: Y
Enumeration Date: 6/20/2005
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