| NPI | 1225115405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALAN COUILLARD President 952-469-8385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MN 3955) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |