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NPI Code Detail

MEDICARE: PEDIATRIC THERAPY SERVICES INC

MEDICARE: PEDIATRIC THERAPY SERVICES 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
1261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1123219OTHERMNUCARE OF MN
278430OTHERMNHEALTH PARTNERS, MN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48B515PEOTHERMNBCBS OF MN PT CLINIC #
58G323PEOTHERMNBCBS OT CLINIC #
68G374PEOTHERMNBCBS SPEECH #
7PREFERRED ONEOTHERMNPREFERRED ONE

General Provider Information

NPI Number : 1376514539
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC THERAPY SERVICES INC
Provider Business Mailing Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Provider Business Practice Location Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Authorized Official
Title or Position : CEO
Name : NANCY D DOBSON
Credential : RPT
Telephone Number : 507-388-5437
Provider Enumeration Date : 01/27/2006
Last Update Date : 08/22/2014

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1124574439 — MELISSA HOKENESS I
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Directions to “PEDIATRIC THERAPY SERVICES INC ” Practice Location

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