Healthcare Provider Details

I. General information

NPI: 1083176101
Provider Name (Legal Business Name): TRANSCEND REHAB & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 1ST ST S STE 110
WILLMAR MN
56201-4271
US

IV. Provider business mailing address

2800 1ST ST S STE 110
WILLMAR MN
56201-4271
US

V. Phone/Fax

Practice location:
  • Phone: 320-318-8812
  • Fax: 320-318-8813
Mailing address:
  • Phone: 320-318-8812
  • Fax: 320-318-8813

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: TAMARA LYNN KOBIENIA
Title or Position: PHYSICAL THERAPIST
Credential: PT, MA
Phone: 320-318-8812