| NPI | 1760058937 |
|---|---|
| Doing Business As | ACTIVE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | GREG MARK GRAY President 952-992-2420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2021-05-28 |