| NPI | 1316344153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER EULL Clinic Manager 320-952-1320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 208D00000X General Practice | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2025-07-22 |