| NPI | 1407869662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN WEAVER CEO 320-240-6955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2010-03-30 |