Individual
JONATHAN MIGUEL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 273-3000
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104330
MN
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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