| NPI | 1821179607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE MORLEY HENJUM Owner 651-348-7428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-08-25 |