| NPI | 1740578749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY L MOYER Owner / Provider 651-282-0948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 35768) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2015-11-04 |