| NPI | 1992986194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEEN GROTH Owner 612-730-8272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MN 100848) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2017-04-07 |