Healthcare Provider Details

I. General information

NPI: 1992043145
Provider Name (Legal Business Name): PT WORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 PARK AVE
MINNEAPOLIS MN
55404-2847
US

IV. Provider business mailing address

7 W FRANKLIN AVE
MINNEAPOLIS MN
55404-2416
US

V. Phone/Fax

Practice location:
  • Phone: 612-315-5682
  • Fax: 612-315-5682
Mailing address:
  • Phone: 612-315-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SIYAD ABDULLAHI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 612-749-3314