| NPI | 1922182120 |
|---|---|
| Other Name | MIDWEST STONE |
| Entity Type | Organization |
| Authorized Contact | CHARLIE NYSTROM COO 651-633-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QL0400X Clinic/Center, Lithotripsy |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |