| NPI | 1750526430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY DALE WILDBERG Owner, President 952-893-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 4267) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |