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Organization
FUNCTIONAL INTEGRATED THERAPY, LTD
Active
Organization
FUNCTIONAL INTEGRATED THERAPY, LTD
Active
Other names
Functional Kids Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI KAY WORRELL OTR/L (OWNER/OPERATOR)
(651) 770-8884
Entity
Organization
Contact information
Practice address
2495 MAPLEWOOD DRIVE, SUITE 313, MAPLEWOOD, MN 55109-1913
(651) 770-8884
(651) 770-8151
Mailing address
2495 MAPLEWOOD DRIVE, SUITE 313, MAPLEWOOD, MN 55109-1913
(651) 770-8884
(651) 770-8151
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
100591
MN
Other
Enumeration date
10/09/2006
Last updated
03/31/2009
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