Provider Demographics
NPI:1477921062
Name:ENGEL, ANNAMARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ANNAMARIE
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11840 64TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-6151
Mailing Address - Country:US
Mailing Address - Phone:651-249-5677
Mailing Address - Fax:
Practice Address - Street 1:500 OSBORNE RD NE STE 365
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-2769
Practice Address - Country:US
Practice Address - Phone:763-236-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-13
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist