Wander, Tara Mae

Wander, Tara Mae is an sole proprietor health care provider with primary practice located at 6500 Excelsior Blvd , St Louis Park MN 55426-4702. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Wander, Tara Mae can be contacted via phone (952) 993-5000.

Contact Information

Primary practice address
6500 Excelsior Blvd St Louis Park MN 55426-4702
Phone: (952) 993-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5880 Minnesota

Profile Details

NPI number 1851342091
LBN Legal business name Wander, Tara Mae
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851342091 NPPES
Other 6400295 MEDICA
Other HP42340 MEDICA
Other 48Q92WA MEDICA

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