NPI | 1902219595 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY LESHER Vice President/Clinical Practice 651-636-4155 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MN 9299) |
Enumeration Date | 2014-06-11 |
Last Update Date | 2014-06-11 |