| NPI | 1427342138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL P VAAGENES Administrator 320-762-6021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 207T00000X Neurological Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2021-06-16 |