NPI | 1144644717 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL HANSON Medical Director 651-324-8693 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 679516700023) |
Enumeration Date | 2014-02-18 |
Last Update Date | 2019-12-19 |