| NPI | 1922486224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSE ELMI Director Of Operations/Owner 612-232-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |