| NPI | 1184610974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN PERL RADJENOVICH President 320-763-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 22233) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2013-01-31 |