NPI | 1154035939 |
---|---|
Doing Business As | ENTIRA FAMILY CLINIC MTM-SHOREVIEW |
Entity Type | Organization |
Authorized Contact | DAVID FASCHING CFO 612-617-3799 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2023-01-06 |
Last Update Date | 2023-04-20 |