| NPI | 1225207343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIANNE PARKS CEO/Licensed Rd 651-592-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2013-02-01 |