| NPI | 1881100089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN DENISE BREY Supervisor/Delegated Official 952-993-6832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 6019472) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2024-11-25 |