NPI | 1508102500 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA HALEY Operations Manager 952-456-6160 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: MN 24538) |
Enumeration Date | 2012-12-19 |
Last Update Date | 2013-09-10 |