| NPI | 1144350935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES V BURTON President 651-287-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MN d03091) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-10-24 |