Individual
MARIE IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3390 ANNAPOLIS LN N STE B, PLYMOUTH, MN 55447-5379
(763) 767-0854
Mailing address
10540 43RD AVE N APT 201, MINNEAPOLIS, MN 55442-2846
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A1573
MN
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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