NPI | 1184867319 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY CHARLES FORS Clinic Director 763-862-7100 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 1836) |
Enumeration Date | 2009-04-17 |
Last Update Date | 2015-05-01 |