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Individual

MARIALENA I DUFAULT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3915 GOLDEN VALLEY RD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0709
(763) 520-0355
Mailing address
3915 GOLDEN VALLEY RD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0709
(763) 520-0355

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5855
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
48Q90MO
BCBS MINNESOTA
01
6411176
MEDICA
01
HP43585
HEALTH PARTNERS
Enumeration date
04/21/2006
Last updated
07/08/2007
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