Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 4570 | MN |
N | 2251X0800X | Physical Therapist - Orthopedic | 4570 | MN |
NPI | 1306893177 |
---|---|
Provider Name | Brenda Peitz Knaeble |
First Address | Big Lake, MN 55309-9493 |
Second Address | Sartell, MN 56377-4202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 08/07/2007 |