| NPI | 1922665488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE SPRADLIN Coordinator 763-546-8051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |