| NPI | 1780621904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JAMES LUHRS VP Finance 952-883-7158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208000000X Pediatrics | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-10-25 |