Healthcare Provider Details

I. General information

NPI: 1780694729
Provider Name (Legal Business Name): KAMI LYNN DAVEY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

20949 400TH ST
ALBANY MN
56307-9627
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-6480
  • Fax: 320-255-6327
Mailing address:
  • Phone: 320-845-7329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6579
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: