NPI | 1548483050 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN SULLIVAN CEO 763-494-4311 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3181) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 3681) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2020-08-22 |