| NPI | 1902293202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN CLARE Owner 612-520-1823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: MN 5856) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |