| NPI | 1609265156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAD CHRISTOPHER BETZOLD Co Owner 651-207-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 6027) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 6028) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |