Healthcare Provider Details

I. General information

NPI: 1942493218
Provider Name (Legal Business Name): FLYING CLOUD PHYSICAL THERAPY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7707 FLYING CLOUD DR
EDEN PRAIRIE MN
55344-3708
US

IV. Provider business mailing address

7707 FLYING CLOUD DR
EDEN PRAIRIE MN
55344-3708
US

V. Phone/Fax

Practice location:
  • Phone: 952-829-7814
  • Fax: 952-829-0051
Mailing address:
  • Phone: 952-829-7814
  • Fax: 952-829-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number7088
License Number StateMN

VIII. Authorized Official

Name: SCOTT MICHEEL ARNESON
Title or Position: OWNER
Credential: DC
Phone: 952-829-7814