Healthcare Provider Details

I. General information

NPI: 1558030098
Provider Name (Legal Business Name): FIRST STEPS PEDIATRIC PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 05/03/2024
Certification Date: 03/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5648 POULIN RD
DULUTH MN
55803-9388
US

IV. Provider business mailing address

5648 POULIN RD
DULUTH MN
55803-9388
US

V. Phone/Fax

Practice location:
  • Phone: 218-591-8768
  • Fax:
Mailing address:
  • Phone: 218-591-8768
  • 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: KATIE MARIE YANKOWIAK
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 218-591-8768