NPI | 1629357918 |
---|---|
Doing Business As | FAIRVIEW BROOKLYN PARK CLINIC MTM |
Entity Type | Organization |
Authorized Contact | DAVID FASCHING CFO 612-617-3799 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2011-08-04 |
Last Update Date | 2023-04-12 |