Healthcare Provider Details

I. General information

NPI: 1083712871
Provider Name (Legal Business Name): MARILYNN POSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 VILLAGE CENTER DR SUITE 220
NORTH OAKS MN
55127-3023
US

IV. Provider business mailing address

100 VILLAGE CENTER DR SUITE 220
NORTH OAKS MN
55127-3023
US

V. Phone/Fax

Practice location:
  • Phone: 651-482-8486
  • Fax:
Mailing address:
  • Phone: 651-482-8486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: