| NPI | 1215601299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BUSH Owner 651-342-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |