| NPI | 1033565510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M MILLER President 612-888-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MN 50690) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |