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General NPI Number Information
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NPI Number | 1780500835
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Entity Type | Individual
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Provider Name | DERRICK REILLY ARTERO
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Gender | Male
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 4155 COUNTY ROAD 101 N
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City | PLYMOUTH
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State | MN
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Zip | 55446-2307
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Country | US
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Telephone | 952-993-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 3436 YUKON AVE S
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-3840
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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 |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | MN
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