# NORTHERN STAR THERAPY LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407869662
- **Authorized official:** DAN WEAVER PT (CEO)
- **Authorized official phone:** (320) 240-6955

## Contact information

- **Practice address:** 166 19TH ST S, SUITE 202, SARTELL, MN 56377-2153
- **Practice address phone:** (320) 257-2225
- **Practice address fax:** (320) 257-2226
- **Mailing address:** 251 COUNTY RD 120, SUITE A, SAINT CLOUD, MN 56303
- **Mailing address phone:** (320) 259-5429
- **Mailing address fax:** (320) 240-8905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 03/30/2010