Individual
MR. STEPHEN THOMAS ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1661 PARK RIDGE DR, CHASKA, MN 55318-2841
(952) 403-3980
(952) 403-3979
Mailing address
500 2ND ST, APT#B2, EXCELSIOR, MN 55331-1967
(952) 403-3923
(952) 403-3979
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102626
MN
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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