| NPI | 1033180930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE A MYREN Assistant Administrator 320-762-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MN 590) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2012-02-08 |