| NPI | 1386824357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JONES Medical Director 218-625-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN 27729) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |