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Individual

DEBRA CORNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 302-4102
(763) 287-2309
Mailing address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 302-4102
(763) 287-2309

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2570
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
44B88CO
BCBS OF MN
MN
01
6401553
MEDICA
MN
01
859687
AMERICA'S PPO
MN
01
962871010735
PREFERRED ONE
MN
01
HP44361
HEALTHPARTNERS
MN
Enumeration date
07/26/2006
Last updated
07/08/2019
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