Individual
MISTY MARIE FARRELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1710 SUBURBAN AVE, SAINT PAUL, MN 55106-6636
(952) 993-5900
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
37453
CA
Other
Enumeration date
02/18/2011
Last updated
07/24/2023
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