Healthcare Provider Details

I. General information

NPI: 1649709403
Provider Name (Legal Business Name): MRS. BARBARA LYNN BEDORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA LYNN FREIMUTH

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 SAINT CROIX AVE N
GOLDEN VALLEY MN
55422-4419
US

IV. Provider business mailing address

8343 MITCHELL RD
EDEN PRAIRIE MN
55347-1503
US

V. Phone/Fax

Practice location:
  • Phone: 763-732-1449
  • Fax:
Mailing address:
  • Phone: 612-306-2750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: