Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10857 | MN |
NPI | 1770119703 |
---|---|
Provider Name | Dr. Anne Christine Mackin Emanuel |
First Address | Savage, MN 55378-1728 |
Second Address | Golden Valley, MN 55422-4249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2020 |
Last Update Date | 21/03/2020 |