| NPI | 1821646985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VITO DIMUCCI Owner, Family Nurse Practitioner 612-805-8676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2025-09-11 |