| NPI | 1922160217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH JANE LORENTZEN President 651-388-0133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN LP 4208) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |