Provider Demographics
NPI:1942310693
Name:DECHAINE, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:DECHAINE
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 1:1432 COUNTY ROAD B W
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-4213
Mailing Address - Country:US
Mailing Address - Phone:651-633-5514
Mailing Address - Fax:
Practice Address - Street 1:60 MARIE AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-5910
Practice Address - Country:US
Practice Address - Phone:651-451-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNPTAOtherPTA