| NPI | 1932244290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M ERICKSON Bus Manager 320-235-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 2107) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 3122) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2008-01-17 |