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NPI Code Detail

MEDICARE: SPOT REHABILITATION INC.

MEDICARE: SPOT REHABILITATION INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist
2225X00000XOccupational Therapist
3225200000XPhysical Therapy Assistant
4225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013919448
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPOT REHABILITATION INC.
Provider Business Mailing Address
First Line : 2835 W SAINT GERMAIN ST
Second Line : SUITE 300
City : SAINT CLOUD
State : MN
Zip : 56301-4743
Country : US
Telephone Number : 320-259-4151
Fax Number : 320-259-5707
Provider Business Practice Location Address
First Line : 2835 W SAINT GERMAIN ST
Second Line : SUITE 300
City : SAINT CLOUD
State : MN
Zip : 56301-4743
Country : US
Telephone Number : 320-259-4151
Fax Number : 320-259-5707
Authorized Official
Title or Position : CEO
Name : MRS. ELIZABETH STEINESSEN
Credential : OTR/L
Telephone Number : 320-259-4151
Provider Enumeration Date : 08/15/2005
Last Update Date : 06/20/2013

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1104809698 — ELIZABETH STIENESSEN OTR/L
Practice Location Address:
2835 W SAINT GERMAIN ST , SUITE 300
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56301-4743
Practice Phone: 320-259-4151
Practice Fax: 320-259-5707

Directions to “SPOT REHABILITATION INC. ” Practice Location

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