| NPI | 1770332975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BRADLEY Owner 701-751-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2024-05-18 |
| Last Update Date | 2024-06-12 |