Individual
PATRICIA MONTIVIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6566 LACASSE DR, LINO LAKES, MN 55038-7721
(651) 324-6256
Mailing address
6566 LACASSE DR, LINO LAKES, MN 55038-7721
(651) 324-6256
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A216
MN
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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