| NPI | 1912325325 |
|---|---|
| Doing Business As | NORTHERN LIFE WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JEFFREY WAYNE DANIELSON Owner/President 952-890-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3374) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8532) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-25 |