| NPI | 1649604513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID COOK CEO 507-289-2089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MN 802789-3-MHC) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2015-03-24 |