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Individual

THERESA IRENE PLASENCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1030 COUNTY ROAD E W STE 240, SHOREVIEW, MN 55126-8153
(651) 493-0626
(651) 493-8463
Mailing address
981 CHATSWORTH PL, SHOREVIEW, MN 55126-2259

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5930
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
109313
HEALTHPARTNERS
MN
01
5606571
FIRST HEALTH
01
60M64PL
BLUECROSS AND BLUE SHIELD
MN
01
64-04673
MEDICA
MN
Enumeration date
03/14/2007
Last updated
04/19/2012
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