Individual
MISS NANCY ANN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 254-3200
Mailing address
11409 RIDGEMOUNT AVE W, MINNETONKA, MN 55305-1455
(651) 328-3107
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105421
MN
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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