| NPI | 1912299405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LYNN POTTEBAUM Chief Manager/Chiropractor 612-741-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 4083) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |