Individual
DR. KIEBORT ANNAS MEEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
955 WILDWOOD RD, WHITE BEAR LAKE, MN 55115-1847
(952) 835-4512
(888) 425-0398
Mailing address
7825 3RD ST N, STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
(888) 425-0398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12193
MN
225100000X
Physical Therapist
TP2020001
KY
Other
Enumeration date
06/09/2020
Last updated
07/13/2021
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