Individual
BETH MARIE JANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3111 124TH AVE NW, COON RAPIDS, MN 55433-1793
(763) 236-8934
Mailing address
11121 ZION ST NW, COON RAPIDS, MN 55433-3524
(763) 236-8934
(763) 236-8930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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