| NPI | 1043729452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED ZACCHEUS PAYNE Authorized Agent 763-234-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-09-28 |