| NPI | 1255339628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATTAS BOUTROUS Administrator 701-221-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2019-10-24 |