| NPI | 1639896913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LEIGH HANSEN Owner 763-465-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-11-10 |