| NPI | 1265404115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY TONE Administrator 320-231-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 327471) |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2012-08-27 |