| NPI | 1700664505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA YOUNG Licensing Specialist 612-840-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |