Healthcare Provider Details

I. General information

NPI: 1053802835
Provider Name (Legal Business Name): ALETHEA SCHAFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 UNIVERSITY AVE W
SAINT PAUL MN
55104
US

IV. Provider business mailing address

1745 JAMES AVE
SAINT PAUL MN
55105-2114
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-7000
  • Fax:
Mailing address:
  • Phone: 612-743-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11126
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: