| NPI | 1255939716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KINGSLEY Owner 612-453-1907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2023-04-26 |