| NPI | 1760417836 |
|---|---|
| Doing Business As | FAIRVIEW SOUTHDALE WEIGHT LOSS SURGERY |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER F. ROLAND President 952-915-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |