NPI | 1457535528 |
---|---|
Doing Business As | FAIRVIEW APPLE VALLEY MTM |
Entity Type | Organization |
Authorized Contact | DAVID FASCHING CFO 612-617-3799 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MN 2625247) |
Enumeration Date | 2007-12-24 |
Last Update Date | 2023-03-16 |