| NPI | 1518141027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN KENNEDY President/Vice President/Treasurer 612-387-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 4999) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |