Provider Demographics
NPI:1245400043
Name:HOVENDICK, SHARI SUSAN (PT)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:SUSAN
Last Name:HOVENDICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10935 COUNTY ROAD 21 SW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-6128
Mailing Address - Country:US
Mailing Address - Phone:320-762-2306
Mailing Address - Fax:
Practice Address - Street 1:515 FRANKLIN ST S
Practice Address - Street 2:PHYSICAL THERAPY
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-1545
Practice Address - Country:US
Practice Address - Phone:320-634-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist