| NPI | 1730232323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL ANDREW BOTTELSON Owner 952-881-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-07-21 |