Individual
SHANNON MAIXNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
688 WILDWOOD RD, MAHTOMEDI, MN 55115-1812
(651) 429-9947
Mailing address
688 WILDWOOD RD, MAHTOMEDI, MN 55115-1812
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4723
MN
225100000X
Physical Therapist
—
—
Other
Enumeration date
09/28/2006
Last updated
03/11/2024
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