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Individual
KENNETH OMUNDSON
Active
Individual
KENNETH OMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2319
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
483T6OM
BCBS
MN
01
—
6404903
MEDICA
MN
01
—
HP49619
HEALTH PARTNERS
MN
Enumeration date
09/29/2006
Last updated
07/09/2007
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