Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 5367 | MN |
NPI | 1255469920 |
---|---|
Provider Name | Mrs. Lynnette Karin Leuty |
First Address | Andover, MN 55304 |
Second Address | Minneapolis, MN 55407-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |