| NPI | 1679989065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE ELIZABETH PARKER Owner 763-229-8508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN R11529-5) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |