Individual
KARMEN RAE DEZEEUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8624 WEDGEWOOD LN N, MAPLE GROVE, MN 55369-4615
(605) 553-5762
Mailing address
8624 WEDGEWOOD LN N, MAPLE GROVE, MN 55369-4615
(605) 553-5762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2481
MN
246ZX2200X
Orthopedic Assistant
Primary
2481
MN
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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