| NPI | 1992954853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM PATRICK SPICER Owner 952-403-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 4654) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MN 4654) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2010-04-21 |