| NPI | 1790145480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J WILL Medical Director 612-991-9433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN 40619) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2025-11-18 |