Healthcare Provider Details

I. General information

NPI: 1447334834
Provider Name (Legal Business Name): DONALD DARLING PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 CHICAGO AVE SUITE 200
MINNEAPOLIS MN
55407-1318
US

IV. Provider business mailing address

7541 9TH ST N
OAKDALE MN
55128-6626
US

V. Phone/Fax

Practice location:
  • Phone: 612-872-2700
  • Fax:
Mailing address:
  • Phone: 651-748-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1726
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: