| NPI | 1629004031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE MORLEY HENJUM Owner 651-348-7432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2026-01-14 |