Healthcare Provider Details

I. General information

NPI: 1780828475
Provider Name (Legal Business Name): BECKY BEST-THORESEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 SO. ST. CROIX TRAIL
AFTON MN
55001
US

IV. Provider business mailing address

1128 ROCKSTONE LN
NEW BRIGHTON MN
55112-1614
US

V. Phone/Fax

Practice location:
  • Phone: 651-436-3747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: