MEDICARE: LAURIE J XIONG PT

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	6144	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952499907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE J XIONG PT

Provider Business Mailing Address
First Line	:	1939 MINNEHAHA AVE W STE 300
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1033
Country	:	US
Telephone Number	:	651-748-4338
Fax Number	:	651-748-2892

Provider Business Practice Location Address
First Line	:	1270 NORTHLAND DR STE 175
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55120-1412
Country	:	US
Telephone Number	:	651-905-9000
Fax Number	:	651-454-1603

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	11/14/2023

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Directions to “ LAURIE J XIONG PT” Practice Location

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