| NPI | 1538213400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE MARIE KUJAWA Manager 218-263-8956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: IA 185019727) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |