| NPI | 1952887051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MALONE Physical Therapist 612-440-6016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2020-10-07 |