| NPI | 1922416064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA ALIZADEH CEO 612-868-6894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: MN 3112) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8737) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |