Healthcare Provider Details

I. General information

NPI: 1851256382
Provider Name (Legal Business Name): CONNOR REIMER CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4632 85TH AVE N
BROOKLYN PARK MN
55443-1957
US

IV. Provider business mailing address

4632 85TH AVE N
BROOKLYN PARK MN
55443-1957
US

V. Phone/Fax

Practice location:
  • Phone: 763-494-4900
  • Fax: 763-494-4902
Mailing address:
  • Phone: 763-494-4900
  • Fax: 763-494-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: