Dr. Todd Laverne Kanzenbach
Family Doctor - Sports Medicine
21 Carkoski Commons Minnesota State University, Mankato
Mankato
, Minnesota 56001-6030
Dr. Todd Laverne Kanzenbach
Family Doctor - Sports Medicine
21 Carkoski Commons Minnesota State University, Mankato
Mankato
, Minnesota 56001-6030
(507) 389-5787
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Todd Laverne Kanzenbach
- 600 Maywood Ave 21 Carkoski Commons
- Mankato, MN
- Zip : 56001-6441
- Fax : (507) 389-5787
- Phone : (507) 389-1430
Second Address
- Dr. Todd Laverne Kanzenbach
- 21 Carkoski Commons Minnesota State University, Mankato
- Mankato, MN
- Zip : 56001-6030
- Fax : (507) 389-5787
- Phone : (507) 389-6276
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 38627 | MN |
National Provider Identifier
| NPI | 1124016597 |
|---|---|
| Provider Name | Dr. Todd Laverne Kanzenbach |
| First Address | Mankato, MN 56001-6441 |
| Second Address | Mankato, MN 56001-6030 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2005 |
| Last Update Date | 20/01/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01-09557 | MEDICA (01) | MN |
| 140293 | UCARE (01) | MN |
| 247M1KA | BCBS (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.