NPI | 1508902636 |
---|---|
Former Legal Business Name | PRO PHYSICAL THERAPY PA |
Entity Type | Organization |
Authorized Contact | MICHAEL FRICKE Owner 952-891-2645 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 2187) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 2187) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2008-06-23 |