| NPI | 1710040456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA LEV POLUKHIN Medical Director 651-699-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 45600) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2009-06-18 |