Healthcare Provider Details

I. General information

NPI: 1306949359
Provider Name (Legal Business Name): NATHAN STIER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7872 CENTURY BLVD
CHANHASSEN MN
55317
US

IV. Provider business mailing address

7872 CENTURY BLVD
CHANHASSEN MN
55317
US

V. Phone/Fax

Practice location:
  • Phone: 952-448-9081
  • Fax: 952-448-9088
Mailing address:
  • Phone: 952-448-9081
  • Fax: 952-448-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number6931
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: