SHAUN DOUGLASS

MAPLE GROVE, MN
NPI1265113450
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MN  A1923)
Enumeration Date2023-07-31
Last Update Date2025-02-04
Business Address
SHAUN DOUGLASS PTA
7767 ELM CREEK BLVD N STE 160
MAPLE GROVE, MN 55369-7078
Phone number: 763-201-8191
Mailing Address
SHAUN DOUGLASS PTA
6145 MACLYNN AVE NE
OTSEGO, MN 55301-4589
Phone number: 763-213-5505
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