| NPI | 1275231698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA C KONRATH Chief Officer 651-440-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2025-06-07 |