| NPI | 1154337913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE K BAVERTY Clinic Administrator 651-224-8264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2010-10-20 |