| NPI | 1871983478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DOLE Owner 952-924-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN 29325) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |