| NPI | 1629484209 |
|---|---|
| Doing Business As | OPTUM CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD SHUMACHER Officer 952-205-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2016-05-03 |