| NPI | 1154575140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW RAWSON Medical Director 612-216-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 35804) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |