| NPI | 1386047330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORD C ERICKSON Owner/Medical Director 651-481-7047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 31075) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |