| NPI | 1659956316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA CLINE HOLUM Senior Director 952-945-4007 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| 208D00000X General Practice | |
| 261QP0905X Clinic/Center Public Health, State or Local | |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2021-03-15 |