| NPI | 1053411280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN F STOCK President 320-208-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 5887419) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |