Individual
KATHRYN ANNE GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1687 WOODLANE DR STE 201, WOODBURY, MN 55125-3047
(651) 738-9888
(651) 738-9889
Mailing address
9725 BELMONT LN, EDEN PRAIRIE, MN 55347-3134
(912) 704-6281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7728
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531G0GA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
08/12/2006
Last updated
07/08/2007
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