Basic Information
| Provider Information | |||||||||
| NPI: | 1588752299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIND | ||||||||
| FirstName: | KARI | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7541 9TH ST N | ||||||||
| Address2: | |||||||||
| City: | OAKDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551286626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517484338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8650 HUDSON BLVD N | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | LAKE ELMO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550429747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517026932 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/02/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 6450 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 140804600 | 05 | MN | MEDICAID |