| NPI | 1992127799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURKE RAFER MAYS President 763-634-5892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN 003502) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |