| NPI | 1881230704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD WALLACE GINKEL Dc 952-908-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine |
| 111N00000X Chiropractor | |
| 208D00000X General Practice | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |