Individual
MATTHEW HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
1925 WOODWINDS DR, WOODBURY, MN 55125-4445
(651) 232-0100
Mailing address
6089 FALCON RIDGE TRL, APPLE VALLEY, MN 55124-5720
(763) 234-2512
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106498
MN
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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