Individual
CARRIE PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1661 PARK RIDGE DR, CHASKA, MN 55318-2841
(952) 428-1265
(952) 428-1266
Mailing address
1661 PARK RIDGE DR, CHASKA, MN 55318-2841
(952) 428-1265
(952) 428-1266
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
8728
MN
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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