Individual
DANE ALLEN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
100 COBBLESTONE LN, BURNSVILLE, MN 55337-4578
(763) 520-0409
Mailing address
766 IDAHO AVE E, SAINT PAUL, MN 55106-1049
(612) 597-6994
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1452
MN
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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