| NPI | 1710403118 |
|---|---|
| Doing Business As | LIV-ON FAMILY CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | FLORENCE FON Owner/Provider 651-666-0915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2014035499) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2021-10-05 |