| NPI | 1770123697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN LOUISE THEIS Business Office Manager 651-602-5326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |