| NPI | 1386374593 |
|---|---|
| Doing Business As | PRIMARY ENT |
| Entity Type | Organization |
| Authorized Contact | JOHN LUTHER BOONE Owner/President 612-406-9966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-11-17 |