Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 9707 | MN |
N | 2251N0400X | Physical Therapist - Neurology |
NPI | 1386047322 |
---|---|
Provider Name | Lauren Frances Hurt |
First Address | Brainerd, MN 56401-0771 |
Second Address | Baxter, MN 56425-2902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2014 |
Last Update Date | 20/08/2020 |