| NPI | 1750451639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD JEREMY PETTERSON Owner President 651-480-1128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3748) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |