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Individual

MS. KATHERINE SEBASTIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
14635 PENNOCK AVE, SUITE #300, APPLE VALLEY, MN 55124-6430
(651) 994-9644
(651) 994-8962
Mailing address
2795 PILOT KNOB ROAD, SUITE #100, EAGAN, MN 55121-1176
(651) 994-9644
(651) 994-8962

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
9432
MN
225100000X
Physical Therapist
Primary
9432
MN
225100000X
Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9432
STATE
MN
Enumeration date
08/14/2013
Last updated
02/09/2015
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