| NPI | 1447229448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE TURNER Clinic Administrator 952-435-0304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 968) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2008-02-11 |