| NPI | 1831443514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PORTER Physical Therapist Assistant 651-254-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MN A1039) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |