Individual
ALLYSON CAROL MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 831-8742
Mailing address
5430 SOUTHRIDGE CIR, WOODBURY, MN 55129-5520
(949) 351-2635
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
4730
MN
225100000X
Physical Therapist
Primary
11489
MN
Other
Enumeration date
05/26/2019
Last updated
08/20/2021
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