| NPI | 1629193446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN E MEYERS Manager Administrator 612-339-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-04-14 |