| NPI | 1245312388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA BANNACH Authorized Official 701-356-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 225X00000X Occupational Therapist (Licence: ND 796) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2023-07-18 |