| NPI | 1073889630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY KIMBALL Contract Manager 763-349-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: FL HCC8239) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2024-05-07 |