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Individual

JOHN HADDAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1812 N SAINT PAUL RD, MAPLEWOOD, MN 55109-4706
(651) 779-8550
Mailing address
440 2ND ST NE, MINNEAPOLIS, MN 55413-2011
(612) 382-8272

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7098
LICENSE #
MN
Enumeration date
08/25/2006
Last updated
07/08/2007
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