Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | A617 | MN |
NPI | 1194160895 |
---|---|
Provider Name | Patty Norby |
First Address | Bloomington, MN 55438-1006 |
Second Address | Bloomington, MN 55438-1006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2013 |
Last Update Date | 08/05/2013 |