Individual
LEE MYRDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
275 PENN AVE N, MINNEAPOLIS, MN 55405-1216
(612) 377-4723
Mailing address
111 MARQUETTE AVE APT 1212, MINNEAPOLIS, MN 55401-2029
(218) 341-3680
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2317
MN
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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