Individual
MRS. RENNA KAY BLAVAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
911 NORTHLAND DR, PRINCETON, MN 55371-2172
(763) 389-6420
Mailing address
14762 309TH AVE NW, PRINCETON, MN 55371-8515
(763) 389-8961
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6434
MN
Other
Enumeration date
11/26/2006
Last updated
07/08/2007
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