| NPI | 1972861417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LYNN MADISON Office Manager 218-727-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |