Individual
MRS. DANA DEEANNE BIRKHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8012
MN
2251S0007X
Sports Physical Therapist
8012
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8012
STATE LICENSE NUMBER
MN
Enumeration date
08/27/2007
Last updated
08/27/2007
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