Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 7950 | MN |
NPI | 1174729909 |
---|---|
Provider Name | Andrea Onstad |
First Address | Richfield, MN 55423-1131 |
Second Address | Saint Paul, MN 55102-2311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 04/06/2010 |