| NPI | 1609531607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY PRANGER CEO/President 218-590-4603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-04 |