| NPI | 1891931218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW RAWSON Medical Director 952-890-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 35804) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |