| NPI | 1962833368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TEUFER Administrative Official 612-761-5638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 209011031) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |