| NPI | 1093922403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LYNN WYTTENBACH Owner 952-830-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 102921) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |