Healthcare Provider Details

I. General information

NPI: 1114689577
Provider Name (Legal Business Name): SYNAPSE MOBILE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 E 3RD ST APT 2
DULUTH MN
55812-1854
US

IV. Provider business mailing address

1346 W ARROWHEAD RD STE 322
DULUTH MN
55811-2218
US

V. Phone/Fax

Practice location:
  • Phone: 218-302-4636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KADY ADAMS
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 906-364-3410