| NPI | 1598343592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA BLAKE Manager Of Reimbursement Services 612-429-6951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2023-04-27 |