| NPI | 1104331438 |
|---|---|
| Doing Business As | HEALTHEAST OAKDALE CLINIC MTM |
| Entity Type | Organization |
| Authorized Contact | ROBERT BEACHER President 612-672-5139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |