Individual
KENT WORRELL MALCOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2450 RIVERSIDE AVE, SUITE R102, MINNEAPOLIS, MN 55454-1450
(612) 273-9400
Mailing address
3320 YOSEMITE AVE S, ST LOUIS PARK, MN 55416-2142
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2414
MN
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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