Provider Demographics
NPI:1043787534
Name:HONZAY, MIRANDA RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:RENEE
Last Name:HONZAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:RENEE
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 353
Mailing Address - Street 2:
Mailing Address - City:DANUBE
Mailing Address - State:MN
Mailing Address - Zip Code:56230-0353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1015 CENTURY AVE SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3817
Practice Address - Country:US
Practice Address - Phone:320-484-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist