NPI | 1245732130 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES LEWIS LAYTART Credentialing Specialist 952-915-6248 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
Enumeration Date | 2018-03-06 |
Last Update Date | 2019-07-19 |