| NPI | 1104286772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMJAD A. SAFVI Medical Director 651-728-1867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: MN 871166400024) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |