| NPI | 1407555758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WYNIA Owner 763-299-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-05-12 |