Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 7311 | MN |
NPI | 1053532150 |
---|---|
Provider Name | Daniel J Vanhouse |
First Address | Blaine, MN 55434-4233 |
Second Address | Blaine, MN 55434-4233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 22/05/2012 |