| NPI | 1255742698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATSI ANN SEERUP Account Technician Ii 701-667-3395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2014-05-19 |