| NPI | 1346836673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L JOHNSON Employee/Employer S Corp 612-332-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2023-12-11 |