Individual
DR. ANDREA MARY MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2399 ARIEL ST #A, SAINT PAUL, MN 55108-2202
(651) 773-0354
Mailing address
2399 ARIEL ST #A, SAINT PAUL, MN 55108-2202
(651) 773-0354
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
10362
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629421482
NPI 2
MN
Enumeration date
10/05/2016
Last updated
02/07/2018
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