Healthcare Provider Details

I. General information

NPI: 1063438216
Provider Name (Legal Business Name): EMILY KATHRYN KAHNERT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 UNIVERSITY AVE W SUITE 189S
SAINT PAUL MN
55114-1052
US

IV. Provider business mailing address

2550 UNIVERSITY AVE W SUITE 189S
SAINT PAUL MN
55114-1052
US

V. Phone/Fax

Practice location:
  • Phone: 651-332-7474
  • Fax: 651-332-7475
Mailing address:
  • Phone: 651-332-7474
  • Fax: 651-332-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7594
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: