# PRESCOTT THERAPIES LLC

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

## Provider details

- **NPI number:** 1487240693
- **Authorized official:** TRAVIS JOHN KIERSTEAD PT (MANAGING MEMBER)
- **Authorized official phone:** (952) 807-7312

## Contact information

- **Practice address:** 825 NICOLLET MALL STE 1947, MINNEAPOLIS, MN 55402-2707
- **Practice address phone:** (952) 200-0215
- **Practice address fax:** (833) 499-1896
- **Mailing address:** 18872 42ND AVE N, PLYMOUTH, MN 55446-3068
- **Mailing address phone:** (952) 807-7312

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/12/2020
- **Last updated:** 11/20/2024