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Individual

MACKENZIE ANN FUNKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1801 AMERICAN BLVD E, BLOOMINGTON, MN 55425-1232
(615) 424-4046
Mailing address
1801 AMERICAN BLVD E, BLOOMINGTON, MN 55425-1232
(615) 424-4046

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106093
MN

Other

Enumeration date
10/02/2019
Last updated
06/16/2021
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