Individual
COLLEEN AMBROZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 2ND ST NE, NEW PRAGUE, MN 56071-1709
(952) 758-4431
Mailing address
301 2ND ST NE, NEW PRAGUE, MN 56071-1709
(952) 758-4431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01033011
PREFFEREDONE CLINIC NUMBE
MN
05
—
430027000
—
MN
01
—
515L6PE
MN BLUE CROSS PROVIDER NU
MN
01
—
6407367
MEDICA PROVIDER NUMBER
MN
01
—
HP77101
HEALTH PARTNERS PROVIDER
MN
Enumeration date
12/20/2006
Last updated
02/15/2021
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