| NPI | 1588050280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK NOLAN CFO 651-312-3105 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2025-06-06 |