Healthcare Provider Details

I. General information

NPI: 1609656552
Provider Name (Legal Business Name): ABIGAIL MICHAELA STEIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ABIGAIL MICHAELA DETTMER

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14451 GRAND AVE S
BURNSVILLE MN
55306-5708
US

IV. Provider business mailing address

14451 GRAND AVE S
BURNSVILLE MN
55306-5708
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-8524
  • Fax:
Mailing address:
  • Phone: 952-993-8524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: