| NPI | 1720112139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA M JACOBSON Billing Manager 218-362-6761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: ND 3820) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-04-02 |