Provider Demographics
NPI:1235857723
Name:BIERL, VICTORIA (LMT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BIERL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:19260 EVANS ST NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-1076
Mailing Address - Country:US
Mailing Address - Phone:763-441-7788
Mailing Address - Fax:
Practice Address - Street 1:19260 EVANS ST NW
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1076
Practice Address - Country:US
Practice Address - Phone:763-441-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist