Provider Demographics
NPI:1841613312
Name:MCGINN, TAMARA
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:MCGINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 E POINT DOUGLAS RD S
Mailing Address - Street 2:SUITE 500
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4159
Mailing Address - Country:US
Mailing Address - Phone:651-459-2000
Mailing Address - Fax:844-270-8025
Practice Address - Street 1:8800 E POINT DOUGLAS RD S
Practice Address - Street 2:SUITE 500
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4159
Practice Address - Country:US
Practice Address - Phone:651-459-2000
Practice Address - Fax:844-270-8025
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist