| NPI | 1780183491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH HALES President/Physical Therapist 612-226-5729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6782) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-04-12 |