Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5194 | MN |
N | 2251G0304X | Physical Therapist - Geriatrics | 000995E | PA |
N | 2251P0200X | Physical Therapist - Pediatrics | 4067 | WI |
NPI | 1083887673 |
---|---|
Provider Name | Mrs. Maureen Charlotte Musselman |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2008 |
Last Update Date | 11/08/2020 |