| NPI | 1023033784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD D JACOBSEN Officer On The Board Secretary 952-543-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |