| NPI | 1649720400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOSEPH KAPAUN VP 218-407-0187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 10421) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |