| NPI | 1396985073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY WADE WHITNEY Physician/President 218-844-6150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 39456) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2013-02-21 |