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Individual

MR. KRIS ANTONI REWALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
(763) 545-0416
(763) 545-2016
Mailing address
271 OAKWOOD DR, SHOREVIEW, MN 55126-4824
(651) 484-9475

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201196
MN

Other

Enumeration date
12/12/2008
Last updated
12/12/2008
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