Organization
MAVERICK PHYSIOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASON RICHLEN DPT, PT (CO-OWNER)
(715) 271-0303
Entity
Organization
Contact information
Practice address
155 EATON ST, SAINT PAUL, MN 55107-1602
(612) 642-1847
Mailing address
155 EATON ST, SAINT PAUL, MN 55107-1602
(612) 642-1847
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
09/10/2021
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