| NPI | 1073698460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET GILBERTSON Practice Manager 701-499-4807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-05-29 |