Individual
THERESA KAYE WICHSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-8583
Mailing address
101 WOODRIDGE DR, CANNON FALLS, MN 55009-9644
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1005
MN
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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