Individual
ERIC STAVENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
(763) 450-6902
Mailing address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9077
MN
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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