| NPI | 1407809494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE MORLEY HENJUM Owner 651-348-7428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-04-13 |