| NPI | 1326308065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SMITH CEO 952-888-4311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TE1100X Psychologist Exercise & Sports | |
| 1041S0200X Social Worker School | |
| 133N00000X Nutritionist | |
| 2251N0400X Physical Therapist Neurology | |
| 2251S0007X Physical Therapist Sports | |
| 225700000X Massage Therapist | |
| 225XN1300X Occupational Therapist Neurorehabilitation | |
| 364SN0800X Clinical Nurse Specialist Neuroscience | |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2012-05-28 |