NPI | 1013056969 |
---|---|
Entity Type | Organization |
Authorized Contact | STACY KOWALKOWSKI Administrator 320-229-1500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: MN 41961) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 41961) |
208100000X Physical Medicine & Rehabilitation (Licence: MN 41961) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 41961) | |
Enumeration Date | 2007-02-06 |
Last Update Date | 2015-07-14 |