| NPI | 1396475927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TJOSVOLD Chief Administrative Officer 763-567-8951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-24 |