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NPI Code Detail

MEDICARE: STEPHANIE BRANCHAUD PT, DPT

MEDICARE: STEPHANIE BRANCHAUD PT, 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
1225100000XPhysical Therapist12094MN

General Provider Information

NPI Number : 1831648922
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE BRANCHAUD PT, DPT
Provider Business Mailing Address
First Line : 9645 GROVE CIR N STE 100
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-2682
Country : US
Telephone Number : 763-302-4114
Fax Number :
Provider Business Practice Location Address
First Line : 9645 GROVE CIR N STE 100
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-2682
Country : US
Telephone Number : 763-302-4114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2016
Last Update Date : 02/25/2022

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Directions to “ STEPHANIE BRANCHAUD PT, DPT” Practice Location

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