| NPI | 1568533909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN VON IDERSTINE Owner 763-533-6775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: MN 1581) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-01-04 |