| NPI | 1720526759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE HANSEN Clinical Director 701-741-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MN CORP00418) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |