| NPI | 1205694742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BERTUCCI Managing Member/Owner 952-232-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-15 |