Healthcare Provider Details

I. General information

NPI: 1073431573
Provider Name (Legal Business Name): MCKENNA ROBB DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SAINT ANDREWS CT STE 310
MANKATO MN
56001-8805
US

IV. Provider business mailing address

150 SAINT ANDREWS CT STE 310
MANKATO MN
56001-8805
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-1811
  • Fax:
Mailing address:
  • Phone: 507-625-1811
  • Fax: 507-388-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14399
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: