Individual
MRS. ELIZABETH MARIE BOESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
825 1ST AVE NW, NEW BRIGHTON, MN 55112-6846
(651) 633-7875
Mailing address
825 1ST AVE NW, NEW BRIGHTON, MN 55112-6846
(651) 633-7875
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1354
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1354
MINNESOTA BOARD OF PHYSICAL THERAPY
MN
Enumeration date
03/29/2010
Last updated
03/29/2010
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