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General NPI Number Information
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NPI Number | 1699582478
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Entity Type | Individual
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Provider Name | ALICIA GONZALEZ ARELLANO PT
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 3815 W BROADWAY AVE
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2207
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Country | US
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Telephone | 612-425-4670
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Fax |
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Provider Business Mailing Address
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Address Line | 14352 WESTRIDGE DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-1737
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Country | US
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Telephone | 405-880-6160
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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 | 4465
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13243
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License Number State | MN
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