| NPI | 1386011682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE WEBER Owner 612-220-5361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 12288-24) |
| Enumeration Date | 2015-08-22 |
| Last Update Date | 2015-08-22 |