| NPI | 1295191708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI LOUSIE WALLIN Manager 612-214-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |