| NPI | 1750378295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA BERRETH Administrator 218-822-2402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 328113) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-08-20 |