Doctor Name: | ANDREA PRICE |
NPI Number: | 1467867010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 9590 |
Business Practice Address: | 5775 Wayzata Blvd Ste 900 Saint Louis Park, MN - 554162674 |
Business Phone Number: | 9524676629 |
Business Fax Number: | |
Mailing Address: | 3465 Zircon Ln N, PLYMOUTH |
State: | MN |
Postal Code: | 554471086 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/23/2014 |
NPI Last Update Date: | 06/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 9590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |