Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 4220 | MN |
N | 2251N0400X | Physical Therapist - Neurology | 4220 | MN |
NPI | 1033266333 |
---|---|
Provider Name | Ms. Jacqueline Kay Harry |
First Address | Minneapolis, MN 55407-3116 |
Second Address | St. Paul, MN 55102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 08/07/2007 |