| NPI | 1528451408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ROBBINS Owner 612-965-2622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 1287) |
| Additional Taxonomies | 251S00000X (Licence: MN 303202) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |