Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 8419 | MN |
NPI | 1083152201 |
---|---|
Provider Name | Kate Brown |
First Address | Saint Paul, MN 55102-2344 |
Second Address | Saint Paul, MN 55102-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 08/02/2017 |