| NPI | 1043722481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HODGDEN Owner 218-639-3449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 10635) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2019-10-07 |