Healthcare Provider Details

I. General information

NPI: 1285848549
Provider Name (Legal Business Name): LEAH RENAE CRUZE D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH RENAE HENTGES D.P.T.

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 NORTHSIDE DR SUITE 200
ALEXANDRIA MN
56308
US

IV. Provider business mailing address

591 NORTHSIDE DR NE STE 200
ALEXANDRIA MN
56308-5063
US

V. Phone/Fax

Practice location:
  • Phone: 320-445-0100
  • Fax: 320-445-0098
Mailing address:
  • Phone: 320-445-0100
  • Fax: 320-445-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7696
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7696
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: