Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5759 | MN |
NPI | 1023228228 |
---|---|
Provider Name | Lisa Marie Schneider |
First Address | Saint Paul, MN 55108-2227 |
Second Address | Fridley, MN 55432-3134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |