Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 9988 | MN |
NPI | 1104292861 |
---|---|
Provider Name | Karla Schneider |
First Address | Shoreview, MN 55126-1960 |
Second Address | Shoreview, MN 55126-1960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2015 |
Last Update Date | 16/04/2018 |