Doctor Name: | MARYKAY HERUTH |
NPI Number: | 1134182504 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 806 |
Business Practice Address: | 13986 Maple Knoll Way Maple Grove, MN - 553694655 |
Business Phone Number: | 7632360200 |
Business Fax Number: | |
Mailing Address: | Po Box 43, Mr 10809 MINNEAPOLIS |
State: | MN |
Postal Code: | 554400043 |
Phone Number: | 6122624813 |
Fax Number: | 6122624194 |
NPI Enumeration Date: | 04/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 806 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |