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Individual

BRUCE KNUDSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2090 WOODWINDS DRIVE, WOODBURY, MN 55125
(651) 968-5802
(651) 968-5898
Mailing address
PO BOX 86 SDS 12 2901, MINNEAOPLIS, MN 55486-2901
(651) 968-5050
(651) 968-5900

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5299
LICENSE#
MN
Enumeration date
05/01/2007
Last updated
10/26/2009
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