| NPI | 1639399041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PAULSON Administrator 320-269-8877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-06-09 |