| NPI | 1184181091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA CLAIR Director/Practice Manager 701-354-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |