| NPI | 1831375237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D. MARLOW President 612-861-2752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MN 002891) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2009-09-22 |