| NPI | 1942536768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY C JOHANNSEN Owner 563-359-4203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2018-08-15 |