| NPI | 1477640613 |
|---|---|
| Doing Business As | FUNCTIONAL KIDS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KRISTI KAY WORRELL Owner/Operator 651-770-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MN 100591) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2009-03-31 |