Individual
KATHERYN M HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8100 HIGHWOOD DR, BLOOMINGTON, MN 55438-1006
(952) 830-9586
Mailing address
8425 PILLSBURY AVE S, BLOOMINGTON, MN 55420-2243
(704) 340-8884
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1572
MN
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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