MEDICARE: MRS. JANELLE MARIE APPLETON P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2969	MN

General Provider Information

NPI Number	:	1184910929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANELLE MARIE APPLETON P.T.

Provider Business Mailing Address
First Line	:	7135 UPPER 136TH ST W
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-7644
Country	:	US
Telephone Number	:	952-997-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	15359 FOUNDERS LN
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-6065
Country	:	US
Telephone Number	:	952-698-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2011
Last Update Date	:	06/20/2011

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