| NPI | 1477799765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROGERS Administrator 320-839-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC0050X Clinic/Center, Critical Access Hospital |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2015-11-09 |