MEDICARE: MISS HANNAH MARIE FRANZ PTA

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	225200000X	Physical Therapy Assistant	A1561	MN

General Provider Information

NPI Number	:	1588914014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HANNAH MARIE FRANZ PTA

Provider Business Mailing Address
First Line	:	16550 W 78TH ST STE B
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55346-4316
Country	:	US
Telephone Number	:	952-873-7400
Fax Number	:	952-873-7408

Provider Business Practice Location Address
First Line	:	16550 W 78TH ST STE B
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55346-4316
Country	:	US
Telephone Number	:	952-873-7400
Fax Number	:	952-873-7408

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

Provider Enumeration Date	:	09/12/2012
Last Update Date	:	09/12/2012

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