Individual
PAUL MICHAEL HEGSTROM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2195 CENTURY AVE S, WOODBURY, MN 55125-2943
(612) 364-1901
Mailing address
10653 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-1543
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106236
MN
Other
Enumeration date
08/03/2020
Last updated
03/08/2021
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