Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 4713 | MN |
NPI | 1558516849 |
---|---|
Provider Name | Gayle Lyn Monteon |
First Address | Blaine, MN 55434-3056 |
Second Address | Minneapolis, MN 55407-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2008 |
Last Update Date | 01/12/2008 |