| NPI | 1265784862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY KOWALKOWSKI Administrator 320-229-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2012-10-05 |