| 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 |