Provider Demographics
NPI:1639314891
Name:SVENNINGSEN, AMELIA QUIGLEY (PT)
Entity Type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:QUIGLEY
Last Name:SVENNINGSEN
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 1:6149 ARCTIC WAY
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-1844
Mailing Address - Country:US
Mailing Address - Phone:952-922-9333
Mailing Address - Fax:
Practice Address - Street 1:7373 FRANCE AVE S STE 204
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4538
Practice Address - Country:US
Practice Address - Phone:952-428-0600
Practice Address - Fax:952-428-0601
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic