Provider Demographics
NPI:1275653479
Name:MCGEE, CHERI ANN (PT)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:ANN
Last Name:MCGEE
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 1:115 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55975-1223
Mailing Address - Country:US
Mailing Address - Phone:866-280-1051
Mailing Address - Fax:763-201-4689
Practice Address - Street 1:115 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55975-1223
Practice Address - Country:US
Practice Address - Phone:866-280-1051
Practice Address - Fax:763-201-4689
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6107225100000X
IA03502225100000X
WI5833-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19540OtherWELLMARK
MN293M1QUOtherBCBS
IAI11288Medicare ID - Type Unspecified