Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 9350 | MN |
NPI | 1285083899 |
---|---|
Provider Name | Kristina Swatfager |
First Address | Minneapolis, MN 55407-3723 |
Second Address | Minneapolis, MN 55407-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2016 |
Last Update Date | 16/12/2019 |