| NPI | 1437799988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA PARKER Director Of Revenue Cycle 651-208-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |