| NPI | 1811923535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MARIE KRAUSE ROBERTS President 218-641-7725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6521) |
| 225100000X Physical Therapist (Licence: ND 1180) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-01-10 |