| NPI | 1326445826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY P. WANGERIN Chief Manager/Secretary 763-432-5073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 4842) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |