| NPI | 1609898600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE E MATTERN Administrator 701-776-5235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-11-23 |