Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 101044 | MN |
NPI | 1285017996 |
---|---|
Provider Name | Ruth Froese |
First Address | Savage, MN 55378-3618 |
Second Address | Savage, MN 55378-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 30/06/2015 |