| NPI | 1356195606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MOKUA Nurse Practitioner 507-398-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QP1100X Clinic/Center Podiatric |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |