| NPI | 1851820799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN MAE MILLER STAI Owner/Provider 320-235-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 2439) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |