Provider Demographics
NPI:1891826194
Name:JIRAN-SALLS, KAREN (PT, PRC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JIRAN-SALLS
Suffix:
Gender:F
Credentials:PT, PRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 RADIO DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9454
Mailing Address - Country:US
Mailing Address - Phone:651-730-7771
Mailing Address - Fax:651-730-7772
Practice Address - Street 1:783 RADIO DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9454
Practice Address - Country:US
Practice Address - Phone:651-730-7771
Practice Address - Fax:651-730-7772
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5412225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist