Most Relevant Information
Provider Data
| NPI Number: | 1003249616 |
| Provider Name: | LAUREN STAVENGER |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 9039 |
Most Important Dates
| Enumeration Date: | 08/19/2013 |
| Last Updated: | 08/19/2013 |
Provider Practice Location
3815 W BROADWAY AVE
ROBBINSDALE
MN
554222207
Practice Location Phone/Fax
| Phone: | 6123324262 |
| Fax: |
Provider Mailing Location
200 NATHAN LN N APT 231
PLYMOUTH
MN
554416486
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |