Individual
MARIANE LYN WALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CIMT
Contact information
Practice address
18055 198TH AVE NW UNIT B161, BIG LAKE, MN 55309-4926
(612) 200-0619
(612) 844-9108
Mailing address
PO BOX 574, BIG LAKE, MN 55309-0574
(612) 200-0619
(612) 844-9108
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8414
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00875211
MEDICARE RAILROAD
IL
Enumeration date
10/13/2009
Last updated
10/12/2022
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