| NPI | 1164574752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE KENT Owner 651-696-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN 2722) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-09-07 |