| NPI | 1588797922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD M BERGAN Owner/President 701-667-0745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-07-31 |