| NPI | 1548446545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M WEST Owner 218-343-0997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 5012) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-01-21 |