| NPI | 1598099772 |
|---|---|
| Doing Business As | THE CLINIC AT WALMART |
| Entity Type | Organization |
| Authorized Contact | KIRK NYBAKKEN Director Of Finance 651-275-3302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MN 238) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MN 238) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2011-01-04 |