# ACTIVE THERAPY MN

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

## Provider details

- **NPI number:** 1730835257
- **Authorized official:** SHELDON HOLLANDER (MANAGING MEMBER)
- **Authorized official phone:** (612) 562-8204

## Contact information

- **Practice address:** 10300 HENNEPIN TOWN RD, EDEN PRAIRIE, MN 55347-5100
- **Practice address phone:** (612) 562-8204
- **Practice address fax:** (763) 328-0111
- **Mailing address:** 6633 N LINCOLN AVE, LINCOLNWOOD, IL 60712-3605
- **Mailing address phone:** (612) 562-8204
- **Mailing address fax:** (763) 328-0111

## 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:** 02/23/2022
- **Last updated:** 03/22/2022