Healthcare Provider Details

I. General information

NPI: 1033020722
Provider Name (Legal Business Name): BERRES PT AND YOGA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 DUNLAP ST N
SAINT PAUL MN
55104-6405
US

IV. Provider business mailing address

975 MARSHALL AVE FL 2
SAINT PAUL MN
55104-6549
US

V. Phone/Fax

Practice location:
  • Phone: 651-253-8903
  • Fax:
Mailing address:
  • Phone: 651-253-8903
  • 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: DANIELLE BERRES
Title or Position: PHYSICAL THERAPIST, OWNER
Credential: DPT
Phone: 651-253-8903