Individual
ANTHONY KOHLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4360 12TH AVE E, SHAKOPEE, MN 55379-1955
(651) 968-5300
(651) 646-0205
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69261
MN
207QS0010X
Sports Medicine (Family Medicine) Physician
69261
MN
Other
Enumeration date
06/14/2011
Last updated
09/10/2024
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