| NPI | 1922296698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN D EMBLOM President 320-251-6422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MN 001968) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2015-09-02 |