Individual
CONNOR ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS OTR/L
Contact information
Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(952) 831-8742
Mailing address
19700 HILLSIDE ST, EXCELSIOR, MN 55331-8768
(952) 456-2420
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105089
MN
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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