| NPI | 1982061750 |
|---|---|
| Doing Business As | LT PROACTIVE CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KAMBIZ FARBAKHSH Owner/Medical Director 612-554-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 207Q00000X Family Medicine | |
| 208000000X Pediatrics | |
| 2085B0100X Radiology, Body Imaging | |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-02-15 |