Healthcare Provider Details

I. General information

NPI: 1265207427
Provider Name (Legal Business Name): BRIAN P STORHAUG DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 05/22/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 NORTHSIDE DR NE SUITE 200
ALEXANDRIA MN
56308
US

IV. Provider business mailing address

2413 BASSWOOD LN
ALEXANDRIA MN
56308-8502
US

V. Phone/Fax

Practice location:
  • Phone: 320-445-0100
  • Fax:
Mailing address:
  • Phone: 320-815-1984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9957
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number9957
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: