Healthcare Provider Details

I. General information

NPI: 1699352807
Provider Name (Legal Business Name): PHYSIO STRONG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 S MAIN ST
LE SUEUR MN
56058-2027
US

IV. Provider business mailing address

517 S MAIN ST
LE SUEUR MN
56058-2027
US

V. Phone/Fax

Practice location:
  • Phone: 507-593-9900
  • Fax:
Mailing address:
  • Phone: 507-593-9900
  • 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: BRENNA SCHMITT
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 507-593-9900