Individual
AMANDA LYNN ENGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 SHAMROCK WAY, MAHTOMEDI, MN 55115-1888
(651) 260-3042
Mailing address
324 SHAMROCK WAY, MAHTOMEDI, MN 55115-1888
(651) 260-3042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11253
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11253
MINNESOTA DEPARTMENT OF PHYSICAL THERAPY
MN
Enumeration date
10/11/2018
Last updated
10/11/2018
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