Healthcare Provider Details

I. General information

NPI: 1912909557
Provider Name (Legal Business Name): MINNESOTA HAND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 DUNLAP ST N SUITE 736
SAINT PAUL MN
55104-4200
US

IV. Provider business mailing address

393 DUNLAP ST N SUITE 736
SAINT PAUL MN
55104-4200
US

V. Phone/Fax

Practice location:
  • Phone: 651-646-4263
  • Fax: 651-646-8010
Mailing address:
  • Phone: 651-646-4263
  • Fax: 651-646-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number100573
License Number StateMN

VIII. Authorized Official

Name: MS. MICHELLE ANNE REINER
Title or Position: OCCUPATIONAL THERAPIST REGISTERED
Credential: OTR/LCHT
Phone: 651-646-4263