Individual
MISS SAMANTHA ROSE CALLISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
420 DELAWARE ST SE, MAYO B455/MMC 106, MINNEAPOLIS, MN 55455-0341
(612) 273-6351
Mailing address
14500 99TH AVE N, MAPLE GROVE, MN 55369-4730
(763) 898-1113
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10070
MN
Other
Enumeration date
06/12/2015
Last updated
11/21/2021
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