MEDICARE: HEATHER M STONE MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6640	MN

General Provider Information

NPI Number	:	1780043240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER M STONE MPT

Provider Business Mailing Address
First Line	:	166 19TH ST S
Second Line	:	SUITE 101
City	:	SARTELL
State	:	MN
Zip	:	56377-4654
Country	:	US
Telephone Number	:	320-230-7788
Fax Number	:	320-230-7789

Provider Business Practice Location Address
First Line	:	2300 24TH ST NW
Second Line	:	SUITE 101
City	:	BEMIDJI
State	:	MN
Zip	:	56601-6379
Country	:	US
Telephone Number	:	218-444-2624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	02/19/2016

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Directions to “ HEATHER M STONE MPT” Practice Location

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