Provider Demographics
NPI:1326495904
Name:SALMEN, CASSANDRA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SALMEN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13939 OLDFIELD RD N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8598
Mailing Address - Country:US
Mailing Address - Phone:651-343-9033
Mailing Address - Fax:
Practice Address - Street 1:12352 DUNEDIN LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-2804
Practice Address - Country:US
Practice Address - Phone:651-343-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150230012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer