| NPI | 1114199635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEYON M SUCHLA Medical Practice Manager 701-476-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 3751) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-09-18 |