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Individual

JOSHUA C FEENEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3580 ARCADE ST STE 150, VADNAIS HEIGHTS, MN 55127-7135
(651) 968-5201
Mailing address
3580 ARCADE ST, STE 150, VADNAIS HEIGHTS, MN 55127

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8677
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004224
IOWA PT LICENSE
IA
01
056608
MEDICARE
CA
01
070-016238
ILLINOIS PT LICENSE NO
IL
01
I18344009
IOWA MEDICARE NO
IA
01
K50540
ILLINOIS MEDICARE PTAN
IL
Enumeration date
03/03/2008
Last updated
09/19/2017
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