| NPI | 1033407945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN O'NEIL Accounting 651-361-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130076) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2011-07-12 |