| NPI | 1992947501 |
|---|---|
| Doing Business As | BODYLOGICMD OF MAPLE GROVE |
| Entity Type | Organization |
| Authorized Contact | GREGORY C PIPPERT Director 866-542-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MN 37489) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |