| NPI | 1104918143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA JEAN DICKERSON Director Of Clinical & Home Based 612-789-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MN HFID-02476 A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2605) |
| 152WV0400X Optometrist, Vision Therapy (Licence: MN 2605) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-08-26 |