| NPI | 1104987494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE D VANDOVER President 320-839-4152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-03-12 |