| NPI | 1750655882 |
|---|---|
| Doing Business As | INTEGRATED CARE BY MEDICA |
| Entity Type | Organization |
| Authorized Contact | GLENN ANDIS Sr. Vice President Gov. Programs 952-992-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 21268142) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2013-11-20 |