| NPI | 1780974998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET ANN LISTEBARGER President 218-759-0835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: MN R107370-6) |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2011-04-10 |