Individual
MARY ELLEN HIMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
429 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-5378
(952) 828-9500
Mailing address
6647 CANTERBURY LN, EDEN PRAIRIE, MN 55346-2842
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10852
MN
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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