Organization
CAPERNAUM PEDIATRIC THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNA OLSON PT (PHYSICAL THERAPIST/OWNER)
(952) 285-2840
Entity
Organization
Contact information
Practice address
6625 LYNDALE AVE S STE 430, RICHFIELD, MN 55423-2373
(952) 285-2840
(952) 285-2830
Mailing address
6625 LYNDALE AVE S STE 430, RICHFIELD, MN 55423-2373
(952) 285-2840
(952) 285-2830
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2304
MN
Other
Enumeration date
08/04/2005
Last updated
02/13/2020
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