Individual
KATHRYN LEE MERYHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3111 124TH AVE NW STE 123, COON RAPIDS, MN 55433-4573
(763) 236-7337
Mailing address
1080 SPERL ST, SAINT PAUL, MN 55118-1658
(651) 769-5150
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10855
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ETB126679257001
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/25/2018
Last updated
06/16/2018
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