| NPI | 1164463659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEEN MEKALA CFO 507-594-6449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2021-03-23 |