Organization
SODERBERG PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELDON SODERBERG PT (OWNER)
(763) 525-9566
Entity
Organization
Contact information
Practice address
2040 DOUGLAS DR N, SUITE 203, GOLDEN VALLEY, MN 55422-3944
(763) 525-9566
Mailing address
3973 ZEALAND AVE N, NEW HOPE, MN 55427-1160
(763) 525-9566
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1821
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035J8SO
MN BCBS
MN
01
—
6401945
MEDICA
MN
01
—
G488
MN UCARE
MN
Enumeration date
08/01/2006
Last updated
08/22/2020
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