| NPI | 1700301884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ALAN BARIBEAU President/Physical Therapist 218-780-4554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6361) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 101012) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-08-09 |