Individual
ALEXANDRA ELIZABETH ILLG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
35 STATE AVE, FARIBAULT, MN 55021-6368
(507) 497-3722
Mailing address
14103 PLYMOUTH AVE, BURNSVILLE, MN 55337-5719
(651) 472-2388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10928
MN
Other
Enumeration date
08/29/2017
Last updated
04/02/2020
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