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Individual

ALLISON GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
200 MAIN AVE S, PARK RAPIDS, MN 56470-1518
(218) 732-0868
Mailing address
200 MAIN AVE S, PARK RAPIDS, MN 56470-1518
(218) 732-0868

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
4063
MN
225200000X
Physical Therapy Assistant
Primary
A1965
MN

Other

Enumeration date
06/05/2015
Last updated
08/07/2015
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