| NPI | 1063782704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYTEY L GILGENBACH Accounting 651-635-0655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MN A637163000) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |