NPI | 1750017646 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSHUA DEMORETT Physical Therapist 612-219-4047 |
Organization Subpart ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
Additional Taxonomies | 225100000X Physical Therapist |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2022-07-25 |
Last Update Date | 2022-07-25 |