Healthcare Provider Details

I. General information

NPI: 1073582342
Provider Name (Legal Business Name): QUANTUM PHYSICAL THERAPY & PERSONAL TRNG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N BROADWAY
SPRING VALLEY MN
55975-1223
US

IV. Provider business mailing address

115 N BROADWAY
SPRING VALLEY MN
55975-1223
US

V. Phone/Fax

Practice location:
  • Phone: 866-280-1051
  • Fax: 763-201-4689
Mailing address:
  • Phone: 866-280-1051
  • Fax: 763-201-4689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHERI ANN MCGEE
Title or Position: PRESIDENT
Credential: PT
Phone: 866-280-1051