Individual
SAMUEL FEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
501 E NICOLLET BLVD, SUITE 100, BURNSVILLE, MN 55337-6732
(952) 460-4900
(952) 460-4901
Mailing address
501 E NICOLLET BLVD, SUITE 100, BURNSVILLE, MN 55337-6732
(952) 460-4900
(952) 460-4901
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
1739
MN
Other
Enumeration date
04/06/2006
Last updated
02/02/2011
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