| NPI | 1275793945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARY WALSH Director 507-210-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MN 7624495) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |