Individual
HOLLY A DEROUCHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3111 124TH AVE NW, SUITE 200, COON RAPIDS, MN 55433-4572
(763) 427-7300
(763) 427-2802
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
8516
MN
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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