NPI 1639131279

Samuel Fedo, ATC

Practitioner Rehabilitation Practitioner Burnsville, MN

Practice location

Address: 501 E Nicollet Blvd Suite 100, Burnsville, MN 55337-6732
Phone: (952) 460-4900
Fax: (952) 460-4901

Registered specialties

Rehabilitation Practitioner Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225400000X Licence 1739 (MN)

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Registry record

NPI: 1639131279
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Apr 2006
Record last updated: 2 Feb 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.