NPI | 1902228356 |
---|---|
Former Name | KATHLEEN KJOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MN 5856) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5856) |
Enumeration Date | 2014-01-19 |
Last Update Date | 2018-09-17 |