| NPI | 1962553917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ZERBA Administrative Office Manager 952-922-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 1056) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-03-10 |