Individual
MARK W SIEWERT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
825 NICOLLET MALL, SUITE 1935, MINNEAPOLIS, MN 55402-2606
(612) 339-2041
(612) 339-2042
Mailing address
825 NICOLLET MALL, SUITE 1935, MINNEAPOLIS, MN 55402-2606
(612) 339-2041
(612) 339-2042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2815
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40B33SI
BC INDIV PROV ID
MN
01
—
6400642
MEDICA INDIV PROV ID
MN
Enumeration date
04/18/2006
Last updated
07/09/2007
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