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Individual

CONNIE LYNN MELBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1160 DANUBE AVE, SHAKOPEE, MN 55379-4637
(612) 272-0175
Mailing address
1160 DANUBE AVE, SHAKOPEE, MN 55379-4637

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A765
MN

Other

Enumeration date
05/12/2014
Last updated
05/12/2014
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