| NPI | 1134780349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEG VIELE Billing Specialist 701-951-9029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-07-17 |