| NPI | 1073847554 |
|---|---|
| Other Name | EAGLE CREEK WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | JENNA KANITZ Office Manager 952-447-3395 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5996) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |