Provider Demographics
NPI:1881046118
Name:JARVI, ANNA (PTA, CLT)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:
Last Name:JARVI
Suffix:
Gender:F
Credentials:PTA, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 VICTORIA ST N APT 207
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-4454
Mailing Address - Country:US
Mailing Address - Phone:320-491-3016
Mailing Address - Fax:
Practice Address - Street 1:2250 VICTORIA ST N APT 207
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-4454
Practice Address - Country:US
Practice Address - Phone:320-491-3016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA189225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant