Jean Renae Omodt, PT
Physical Therapist in Minneapolis, MN. Individual provider (NPI-1).
NPI number1700969342
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1700969342
- Entity type
- Individual (NPI-1)
- Name
- Jean Renae Omodt
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 2121 | MN | Yes |
Practice location
2450 Riverside AveMinneapolis, MN 55454-1450
Phone 612-672-6000
Mailing address
1915 Stanford AveSaint Paul, MN 55105-1653
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