MEDICARE: MRS. SIERRA E POLLOCK PT, DPT

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	13636	MN

General Provider Information

NPI Number	:	1831921675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SIERRA E POLLOCK PT, DPT

Provider Business Mailing Address
First Line	:	6000 SPRINGS WAY APT 6212
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-0060
Country	:	US
Telephone Number	:	651-470-5432
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 SPRINGS WAY APT 6212
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-0060
Country	:	US
Telephone Number	:	651-470-5432
Fax Number	:

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

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	01/30/2025

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