Healthcare Provider Details

I. General information

NPI: 1003047861
Provider Name (Legal Business Name): EMILY JOANNE HELGESON PT,DPT,CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY JOANNE LEVI

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4289 UGSTAD RD
HERMANTOWN MN
55811-3615
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-3100
  • Fax:
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPTP-PT-LIC-12859
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18704
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9252
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: