| NPI | 1427171636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISA T MITSKOG President 701-642-6480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: ND 500) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 289) |
| 111N00000X Chiropractor (Licence: ND 750) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2013-04-22 |