Provider Demographics
NPI:1306329446
Name:RUHLAND, KENDRIA JEAN (DPT)
Entity type:Individual
Prefix:
First Name:KENDRIA
Middle Name:JEAN
Last Name:RUHLAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 OXBOROUGH AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3036
Mailing Address - Country:US
Mailing Address - Phone:952-843-8280
Mailing Address - Fax:
Practice Address - Street 1:5900 GREEN OAK DR STE 200
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-4797
Practice Address - Country:US
Practice Address - Phone:952-926-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA093661225100000X
MN11303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U4927557906OtherCIGNA