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General NPI Number Information
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NPI Number | 1699165050
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Entity Type | Organization
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Legal Business Name | ALLINA HEALTH
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 1629 E DIVISION ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-1571
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Country | US
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Telephone | 715-307-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | PENNY WHEELER
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Credential | MD
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Telephone | 612-262-4971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2753
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License Number State | WI
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