| NPI | 1609097849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDETTE VIOLA NORDBY Office Manager 952-915-8324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MN 26306) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2009-01-22 |