| NPI | 1740222496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA V SHEVELEVA Financial Controller 952-933-1121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-11-30 |