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NPI Code Detail

MEDICARE: BETH ANN PESTA PT

MEDICARE: BETH ANN PESTA 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
12251X0800XOrthopedic Physical Therapist8181MN

General Provider Information

NPI Number : 1659526903
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH ANN PESTA PT
Provider Business Mailing Address
First Line : 4200 DAHLBERG DR STE 300
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-4841
Country : US
Telephone Number : 952-512-5600
Fax Number : 952-512-5651
Provider Business Practice Location Address
First Line : 9630 GROVE CIR N STE 200
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-3492
Country : US
Telephone Number : 763-520-7870
Fax Number : 763-520-7580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2008
Last Update Date : 02/12/2025

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Directions to “ BETH ANN PESTA PT” Practice Location

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