Individual
MRS. PATRICIA A. MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ATC
Contact information
Practice address
10961 CLUBWEST PKWY NE, SUITE 200, BLAINE, MN 55449
(763) 528-2992
Mailing address
349 120TH CIR NW, COON RAPIDS, MN 55448-2415
(630) 930-9631
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096-001286
IL
2255A2300X
Athletic Trainer
Primary
2666
MN
Other
Enumeration date
04/13/2006
Last updated
12/02/2022
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