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Michelle Marie Perault-Boughton, PT

Physical Therapist in Robbinsdale, MN. Individual provider (NPI-1).

NPI number1346357035
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1346357035
Entity type
Individual (NPI-1)
Name
Michelle Marie Perault-Boughton
Credential
PT
Sex
Female
Sole proprietor
No
Enumeration date
Aug 25, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist4137MNYes

Practice location

4080 W Broadway Ave
#300
Robbinsdale, MN 55422-5604

Phone 763-533-0541

Mailing address

1330 Xerxes Ave N
Minneapolis, MN 55411-2848

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