| NPI | 1285811612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ROUW Vice President 320-252-2963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 486) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 486) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2013-02-04 |