Healthcare Provider Details
I. General information
NPI: 1275683864
Provider Name (Legal Business Name): ANGELA MORROW REHABILITATION PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 MAIN ST SE SUITE 132
MINNEAPOLIS MN
55414
US
IV. Provider business mailing address
125 MAIN ST SE SUITE 132
MINNEAPOLIS MN
55414
US
V. Phone/Fax
- Phone: 612-378-9300
- Fax: 612-676-0225
- Phone: 612-378-9300
- Fax: 612-676-0225
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 4120 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 4120 |
| License Number State | MN |
VIII. Authorized Official
Name: DR.
ANGELA
APRIL
SCHULZ
Title or Position: OWNER
Credential: DC
Phone: 612-378-9300