Doctor Name: | MS. CHRISTINA MARIE WOLF |
NPI Number: | 1073857249 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 9209 |
Business Practice Address: | 300 Coon Rapids Blvd Nw Ste 200 Coon Rapids, MN - 554335645 |
Business Phone Number: | 7637670854 |
Business Fax Number: | |
Mailing Address: | 3333 Harbor Ln N, Apt 6-314 PLYMOUTH |
State: | MN |
Postal Code: | 554475269 |
Phone Number: | 5073019976 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2012 |
NPI Last Update Date: | 11/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 9209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |