Doctor Name: | MARY FENN |
NPI Number: | 1366630147 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6411-24 |
Business Practice Address: | 2225 Dahl Ave E Saint Paul, MN - 551195886 |
Business Phone Number: | 6515789171 |
Business Fax Number: | |
Mailing Address: | 2225 Dahl Ave E, SAINT PAUL |
State: | MN |
Postal Code: | 551195886 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/05/2007 |
NPI Last Update Date: | 10/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6411-24 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |