Individual
PAULETTE REVEIZ THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15800 95TH AVE N, MAPLE GROVE, MN 55369-4400
(952) 993-7353
Mailing address
6465 WAYZATA BLVD, STE 315, MINNEAPOLIS, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6595
MN
Other
Enumeration date
10/14/2006
Last updated
07/08/2007
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