| NPI | 1568557544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMY J TVEDTEN Clinic Administrator 507-526-7388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 1475) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |