Individual
ANNAMARIA MCCONVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2125 E HENNEPIN AVE STE 300, MINNEAPOLIS, MN 55413-1763
(612) 750-7168
(612) 564-7373
Mailing address
4014 RUSSELL AVE N, MINNEAPOLIS, MN 55412-1546
(612) 845-0707
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7889
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831231281
AMERICA'S PPO
MN
01
—
6408307
MEDICA
MN
01
—
71L65MC
BCBS OF MN
MN
01
—
962871052892
PREFERRED ONE
MN
01
—
HP85049
HEALTHPARTNERS
MN
Enumeration date
02/13/2007
Last updated
07/19/2019
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