| NPI | 1821476920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN DENISE BREY Supervisor/Delegated Official 952-993-6832 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2024-11-07 |