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General NPI Number Information
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NPI Number | 1598713109
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Entity Type | Individual
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Provider Name | MARY ELIZABETH HUSBAND PT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13100 WAYZATA BLVD
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City | MINNETONKA
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State | MN
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Zip | 55305-1802
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Country | US
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Telephone | 952-545-0663
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Fax | 952-545-0664
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Provider Business Mailing Address
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Address Line | 10424 BLUFF RD
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-5008
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Country | US
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Telephone | 952-941-1768
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Fax | 952-942-9346
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5255
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License Number State | MN
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