| NPI | 1629474531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW G THORSON Owner/Medical Director 612-207-7463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |