| NPI | 1871684670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN KUFFEL Administrator 952-253-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 1382) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-07-18 |