Organization
LAKE SUPERIOR PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI L WALLEN (BUSINESS MANAGER)
(218) 625-6300
Entity
Organization
Contact information
Practice address
215 N CENTRAL AVE, 14B, DULUTH, MN 55807-2402
(218) 625-6300
(218) 724-6700
Mailing address
215 N CENTRAL AVE, 14B, DULUTH, MN 55807-2402
(218) 625-6300
(218) 724-6700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/05/2005
Last updated
02/25/2015
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