| Doctor Name: | MS. JAMIE VIDINICH |
| NPI Number: | 1194988097 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 8545 |
| Business Practice Address: | 333 Smith Ave N Saint Paul, MN - 551022344 |
| Business Phone Number: | 6512418290 |
| Business Fax Number: | |
| Mailing Address: | 3820 Grand Way, C519 ST LOUIS PARK |
| State: | MN |
| Postal Code: | 554164903 |
| Phone Number: | 7734957218 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2008 |
| NPI Last Update Date: | 08/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 8545 |
| 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 |