Healthcare Provider Details

I. General information

NPI: 1174740930
Provider Name (Legal Business Name): KAREN SUE FRUEHAUF P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 28TH ST
MINNEAPOLIS MN
55407-3723
US

IV. Provider business mailing address

10531 HIDDEN OAKS LN N
CHAMPLIN MN
55316-3045
US

V. Phone/Fax

Practice location:
  • Phone: 763-863-4447
  • Fax:
Mailing address:
  • Phone: 763-576-3105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5395
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: