| NPI | 1740211267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD M BERGAN Owner/President 701-667-0745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-07-31 |