| NPI | 1508018490 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PRESTON FORTHUN Chiropractor/Athletic Trainer 612-823-2020 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: MN 4690) | 
| Enumeration Date | 2008-10-22 | 
| Last Update Date | 2008-10-22 |