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Individual

MISS GLENNA RUTH CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1119 OWENS ST N, STILLWATER, MN 55082-4316
(651) 439-7180
Mailing address
835 7TH ST SW, PINE CITY, MN 55063-2036

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1488
MN

Other

Enumeration date
06/10/2013
Last updated
06/10/2013
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