| NPI | 1194904417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS DAVID CRAIN President 651-451-1012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 1591) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2024-11-26 |