| NPI | 1871760884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A JOHNSON Owner Chiropractor 612-332-8292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3167) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 4790) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-20 |