Individual
MARIA EYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12217 CHAMPLIN DR, CHAMPLIN, MN 55316-1930
(763) 323-1492
Mailing address
1621 LOIS DR, SHOREVIEW, MN 55126-4931
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7107
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497S7EY
BCBS
MN
01
—
6403745
MEDICA
MN
01
—
HP43916
HP
MN
Enumeration date
03/26/2007
Last updated
12/30/2013
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