NPI | 1245475797 |
---|---|
Entity Type | Organization |
Authorized Contact | GABRIEL THOMAS EVENSON President 701-200-8181 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: ND 995) |
Enumeration Date | 2008-12-12 |
Last Update Date | 2008-12-12 |