Individual
NICOLE M LAVANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
715 S 8TH ST FL 3, MINNEAPOLIS, MN 55404-7530
(612) 873-4524
(612) 873-1608
Mailing address
6515 BARRIE RD, SUITE 100, EDINA, MN 55435-2305
(952) 922-5019
(952) 922-1384
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7672
MN
Other
Enumeration date
11/17/2005
Last updated
11/19/2024
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