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General NPI Number Information
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NPI Number | 1720970759
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Entity Type | Organization
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Legal Business Name | ENHANCE PT LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 1826 NORTHWESTERN AVE S
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City | STILLWATER
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State | MN
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Zip | 55082-7533
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Country | US
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Telephone | 651-369-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 4413 HAMLET AVE N
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City | OAKDALE
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State | MN
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Zip | 55128-2631
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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 | PRESIDENT
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Name | BETHANY REUTER
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Credential | PT, DPT
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Telephone | 507-317-3489
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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 |
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License Number State |
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