# IMPACT PHYSICAL MEDICINE OF ST. PAUL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Impact Physical Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487294401
- **Authorized official:** STAN BABEL (CEO)
- **Authorized official phone:** (651) 592-9402

## Contact information

- **Practice address:** 1600 UNIVERSITY AVE W STE 10, SAINT PAUL, MN 55104-3898
- **Practice address phone:** (651) 592-9402
- **Practice address fax:** (651) 641-0726
- **Mailing address:** 1600 UNIVERSITY AVE W STE 10, SAINT PAUL, MN 55104-3898
- **Mailing address phone:** (651) 592-9402
- **Mailing address fax:** (651) 641-0726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2020
- **Last updated:** 01/07/2020