Provider Demographics
NPI:1770119703
Name:EMANUEL, ANNE CHRISTINE MACKIN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:CHRISTINE MACKIN
Last Name:EMANUEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:CHRISTINE
Other - Last Name:MACKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:7500 138TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-1728
Mailing Address - Country:US
Mailing Address - Phone:920-664-5322
Mailing Address - Fax:
Practice Address - Street 1:3915 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4249
Practice Address - Country:US
Practice Address - Phone:612-775-7935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN108572251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology