Individual
DANIELLE PROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
701 HORIZON CIR, CLOQUET, MN 55720-3051
(218) 879-6956
Mailing address
10653 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-1543
(952) 224-1919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9184
MN
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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