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Individual

MS. KATY LYNN PRENEVOST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
800 E 28TH ST # 1750, MINNEAPOLIS, MN 55407-3723
(612) 863-4466
Mailing address
800 E 28TH ST # 1750, MINNEAPOLIS, MN 55407-3723
(612) 863-4466

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8184
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8184
PT LICENSE #
MN
Enumeration date
12/10/2008
Last updated
12/10/2008
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