IAN PROVENCE

COON RAPIDS, MN
NPI1225849870
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2251X0800X Physical Therapist, Orthopedic
Enumeration Date2025-01-14
Last Update Date2025-01-14
Business Address
IAN PROVENCE DPT
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433-5841
Phone number: 763-228-2781
Mailing Address
IAN PROVENCE DPT
7226 58TH AVE N
MINNEAPOLIS, MN 55428-3222
Phone number:
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