| NPI | 1649817883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BLAIR Owner 701-361-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2019-12-20 |