Healthcare Provider Details

I. General information

NPI: 1831475789
Provider Name (Legal Business Name): CHELSIE RINEDOLLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2011
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 GALTIER ST
SAINT PAUL MN
55103-2358
US

IV. Provider business mailing address

4439 MINNEHAHA AVE UNIT 1
MINNEAPOLIS MN
55406-4071
US

V. Phone/Fax

Practice location:
  • Phone: 651-251-3357
  • Fax: 651-224-9613
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA1263
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: