| NPI | 1730603622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL PAUL HARMS CEO 218-481-7812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 384481) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2018-04-23 |