Provider Demographics
NPI:1669775342
Name:KRAUSHAAR, MELANIE MARIE (DPT, CMTPT)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MARIE
Last Name:KRAUSHAAR
Suffix:
Gender:F
Credentials:DPT, CMTPT
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Mailing Address - Street 1:8425 SEASONS PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4392
Mailing Address - Country:US
Mailing Address - Phone:651-415-4140
Mailing Address - Fax:651-739-9197
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-254-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN8494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist