| NPI | 1649350844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA L MOON Insurance COO Rdinator 701-232-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-11-13 |