| NPI | 1952348013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEESA A BRORBY Administrator 701-222-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-04-24 |