| NPI | 1750627048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BRUCE GRAHAM Owner 763-689-2183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 303) |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2013-02-21 |