| NPI | 1851464036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CHARLES GUSTAFSON CEO,Chiropractor 612-709-3104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 2493) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |