| NPI | 1275294894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW INDRESANO Physician 612-202-0179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-10 |