MEDICARE: MRS. ALLISON MARIE BIESANZ 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	7649	MN

General Provider Information

NPI Number	:	1467677286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON MARIE BIESANZ P.T.

Provider Business Mailing Address
First Line	:	320 ELM ST
Second Line	:
City	:	WINONA
State	:	MN
Zip	:	55987-2055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1347 W BROADWAY ST
Second Line	:
City	:	WINONA
State	:	MN
Zip	:	55987-2327
Country	:	US
Telephone Number	:	507-454-3621
Fax Number	:	507-452-2556

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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Directions to “ MRS. ALLISON MARIE BIESANZ P.T.” Practice Location

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