| NPI | 1447493390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN M SCHUNK Administrative Manager 612-369-4775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2009-04-08 |