Individual
TINA MARIE GAPEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 520-0351
Mailing address
933 DEERFIELD RD, WATERTOWN, MN 55388-9271
(952) 955-3270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6960
MN
Other
Enumeration date
04/03/2007
Last updated
08/06/2009
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