Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 009799 | CT |
Y | 225100000X | Physical Therapist | 9562 | MN |
N | 2251S0007X | Physical Therapist - Sports | 10590-024 | WI |
NPI | 1265575070 |
---|---|
Provider Name | Corey Matthew Kunzer |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 11/08/2020 |