| NPI | 1487798633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI DREBENSTEDT Business Office Manager 952-943-0027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |