Individual
MARIAH ELIZABETH EMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6465 WAYZATA BLVD STE 315, ST LOUIS PARK, MN 55426-1730
(952) 993-7169
(952) 993-0300
Mailing address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5841
(763) 236-1035
(763) 236-1086
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7790
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922106913
—
MN
Enumeration date
09/21/2006
Last updated
05/01/2009
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