| NPI | 1891186953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN SULLIVAN CEO 612-670-6330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN 3681) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |