MEDICARE: KELLY LENK DPT

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
1	225100000X	Physical Therapist	11518	MN

General Provider Information

NPI Number	:	1265295976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY LENK DPT

Provider Business Mailing Address
First Line	:	6600 FRANCE AVE S STE 164
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-1802
Country	:	US
Telephone Number	:	952-600-5882
Fax Number	:	844-444-0718

Provider Business Practice Location Address
First Line	:	6600 FRANCE AVE S STE 164
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-1802
Country	:	US
Telephone Number	:	952-600-5882
Fax Number	:	844-444-0718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/06/2026

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