| NPI | 1902931199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN STEVEN ANDERSON Chief Manager 612-735-1469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |