Provider Demographics
NPI:1619181013
Name:HOWE, THERESA JOYCE (MPT,CLT)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:JOYCE
Last Name:HOWE
Suffix:
Gender:F
Credentials:MPT,CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44105 HAWES BEACH ROAD
Mailing Address - Street 2:
Mailing Address - City:OTTERTAIL
Mailing Address - State:MN
Mailing Address - Zip Code:56571
Mailing Address - Country:US
Mailing Address - Phone:218-367-3307
Mailing Address - Fax:
Practice Address - Street 1:415 JEFFERSON ST N
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1264
Practice Address - Country:US
Practice Address - Phone:218-631-7475
Practice Address - Fax:218-632-8765
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5894225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist