Individual
ELIZABETH STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23618 CARMEN CT N, ROGERS, MN 55374-8791
(612) 418-6979
Mailing address
23618 CARMEN CT N, ROGERS, MN 55374-8791
(612) 418-6979
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102067
MN
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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