| NPI | 1649063892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELINDA MILFORD President, Treasurer, Secretary 612-225-9608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-08-12 |