Organization
ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BERTUCCI DPT (MANAGING MEMBER/OWNER)
(952) 232-5020
Entity
Organization
Contact information
Practice address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 232-5020
Mailing address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 232-5020
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/15/2024
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