MEDICARE: BRIGID A DALY PT

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	2668	MN

General Provider Information

NPI Number	:	1366513566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIGID A DALY PT

Provider Business Mailing Address
First Line	:	6465 WAYZATA BLVD
Second Line	:	SUITE 315
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-1728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3529 PENNSYLVANIA AVE S
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-4017
Country	:	US
Telephone Number	:	952-932-0050
Fax Number	:

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

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	07/08/2007

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Directions to “ BRIGID A DALY PT” Practice Location

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