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NPI Code Detail

MEDICARE: COLLEEN MARTENS ENDRIZZI, INC.

MEDICARE: COLLEEN MARTENS ENDRIZZI, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist101152MN
2235Z00000XSpeech-Language Pathologist5742MN

General Provider Information

NPI Number : 1538395926
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLLEEN MARTENS ENDRIZZI, INC.
Provider Business Mailing Address
First Line : 6311 WAYZATA BLVD
Second Line : SUITE 210
City : ST LOUIS PARK
State : MN
Zip : 55416-1209
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6311 WAYZATA BLVD
Second Line : SUITE 210
City : ST LOUIS PARK
State : MN
Zip : 55416-1209
Country : US
Telephone Number : 952-545-0200
Fax Number :
Authorized Official
Title or Position : CEO
Name : COLLEEN MARTENS ENDRIZZI
Credential :
Telephone Number : 612-554-5005
Provider Enumeration Date : 05/31/2009
Last Update Date : 06/11/2009

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Directions to “COLLEEN MARTENS ENDRIZZI, INC. ” Practice Location

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