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Organization
MINNESOTA MEDICAL AND REHABILITATIVE SERVICES, LLC
Active
Organization
MINNESOTA MEDICAL AND REHABILITATIVE SERVICES, LLC
Active
Other names
Minnesota Medical and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB I MIRMAN MD (MANAGING PARTNER)
(952) 933-8900
Entity
Organization
Contact information
Practice address
4201 EXCELSIOR BLVD, ST. LOUIS PARK, MN 55416-4728
(952) 564-3880
(952) 945-9536
Mailing address
4201 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-4728
(952) 933-8900
(952) 945-9536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1544
MN
225100000X
Physical Therapist
2264
MN
225100000X
Physical Therapist
5806
MN
225X00000X
Occupational Therapist
102980
MN
235Z00000X
Speech-Language Pathologist
5169
MN
235Z00000X
Speech-Language Pathologist
6034
MN
Other
Enumeration date
11/11/2005
Last updated
09/18/2025
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