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General NPI Number Information
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NPI Number | 1609829621
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Entity Type | Individual
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Provider Name | TERA DEEANN PAULSON PT
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 430 5TH ST N
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City | BRECKENRIDGE
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State | MN
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Zip | 56520-1426
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Country | US
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Telephone | 701-242-7323
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Fax | 701-242-7797
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Provider Business Mailing Address
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Address Line | 430 5TH ST N
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City | BRECKENRIDGE
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State | MN
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Zip | 56520-1426
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Country | US
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Telephone | 701-242-7323
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Fax | 701-242-7797
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6871
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7835
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1473
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License Number State | ND
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