| NPI | 1235480583 |
|---|---|
| Former Legal Business Name | SEISMIC MEDICAL GROUP PC |
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2019-08-20 |