Individual
AUDRA LYNN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-8091
Mailing address
1509 WINNETKA AVE N, CHAMPLIN, MN 55316-2050
(612) 275-5485
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
A410
MN
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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