Individual
HAILEY PHOULAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
DPT
Contact information
Practice address
60 MARIE AVE E STE 203, WEST ST PAUL, MN 55118-5932
(651) 451-6156
(651) 451-0387
Mailing address
897 REDWELL LN, APPLE VALLEY, MN 55124-8943
(612) 709-1395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14100
MN
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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