| NPI | 1760789259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON KLEFSAAS Executive Director Of Operations 651-631-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-09-22 |