Individual
KIMBERLY LYNN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4010 W 65TH ST, EDINA, MN 55435-1706
(952) 456-7000
(952) 456-7001
Mailing address
3500 AMERICAN BLVD W STE 300, BLOOMINGTON, MN 55431-4442
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
104692
MN
Other
Enumeration date
09/08/2014
Last updated
02/12/2024
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