| NPI | 1902836133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI OHLAND Administrator 651-430-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2019-03-15 |