| NPI | 1649391772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEV KRIEG Office Manager 952-920-6825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 28533) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |