| NPI | 1477598118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A JOHNSON Chief Operating Officer 612-884-0802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2013-02-20 |