Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1245828771 |
---|---|
Provider Name | Madeline Mcgill |
First Address | Edina, MN 55435-2199 |
Second Address | Edina, MN 55435-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2021 |
Last Update Date | 10/01/2021 |