Individual
SANDRA ANN WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2805 CAMPUS DR, #115, PLYMOUTH, MN 55441-2676
(763) 551-9511
Mailing address
14489 64TH AVE N, MAPLE GROVE, MN 55311-4107
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2429
MN
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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