| NPI | 1821410143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PERRON At Consultant 952-278-0559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: MN 2144362) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |