| NPI | 1336765098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE NAVARRETE Business Manager 651-456-8795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2024-10-15 |