| NPI | 1316212970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL B JACKSON COO 612-767-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 1274888-2) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |