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Individual

DEANNA ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
Mailing address
1951 MALVERN ST, LAUDERDALE, MN 55113-5133
(651) 276-6873

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2465
MN

Other

Enumeration date
12/18/2013
Last updated
05/25/2016
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