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NPI Code Detail

MEDICARE: DENISE SMALL

MEDICARE: DENISE SMALL
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
1225100000XPhysical Therapist11429MN
2208100000XPhysical Medicine & Rehabilitation Physician11429MN

General Provider Information

NPI Number : 1699200626
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE SMALL
Provider Business Mailing Address
First Line : 5400 FRANCE AVE S
Second Line :
City : EDINA
State : MN
Zip : 55410-2356
Country : US
Telephone Number : 952-835-4512
Fax Number :
Provider Business Practice Location Address
First Line : 5400 FRANCE AVE S
Second Line :
City : EDINA
State : MN
Zip : 55410-2356
Country : US
Telephone Number : 952-835-4512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2017
Last Update Date : 11/01/2022

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Directions to “ DENISE SMALL ” Practice Location

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