Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 87355 | MN |
Y | 213ES0000X | Sports Medicine | 87355 | MN |
NPI | 1023517364 |
---|---|
Provider Name | Miss Hannah Rhiannon Salisbury |
First Address | Arden Hills, MN 55112-6902 |
Second Address | Arden Hills, MN 55112-6902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2018 |
Last Update Date | 01/02/2018 |