| NPI | 1720431802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL NELSON President 701-365-8134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 103921) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9645) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |