NPI | 1669496345 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT KETOVER President 612-871-1145 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN Pending) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2024-04-02 |