| NPI | 1083056584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN THOMAS GIBSON Chief Pharmacist 320-762-1534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MN 116035) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |