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General NPI Number Information
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NPI Number | 1225768161
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Entity Type | Individual
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Provider Name | MADELINE ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 14451 GRAND AVE
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City | BURNSVILLE
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State | MN
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Zip | 55306-5708
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Country | US
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Telephone | 952-993-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS 21110Q
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City | BLOOMINGTON
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State | MN
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Zip | 55425
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12678
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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