NPI | 1326183609 |
---|---|
Doing Business As | FAIRVIEW EAGAN CLINIC MTM |
Entity Type | Organization |
Authorized Contact | DAVID FASCHING CFO 612-617-3799 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MN 2625276) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2023-04-12 |