Basic Information
Provider Information
NPI: 1609944255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GERMANN
FirstName: SWEN-MARIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
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Mailing Information
Address1: 7551 9TH ST N
Address2: SUITE 100
City: OAKDALE
State: MN
PostalCode: 551286629
CountryCode: US
TelephoneNumber: 6517484338
FaxNumber: 6517482892
Practice Location
Address1: 3311 COUNTY ROAD 101 S
Address2: SUITE 2
City: WAYZATA
State: MN
PostalCode: 553912879
CountryCode: US
TelephoneNumber: 9523034550
FaxNumber: 9524068060
Other Information
ProviderEnumerationDate: 12/01/2006
LastUpdateDate: 06/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X6544MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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