Individual
LAUREN STAVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(612) 332-4262
Mailing address
200 NATHAN LN N APT 231, PLYMOUTH, MN 55441-6486
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9039
MN
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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