| NPI | 1972563815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L. SCZEPANSKI Vice President 701-775-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ND 8411) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: ND 8411) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-05-11 |