Organization
PHYSICAL THERAPY CONSULTANTS, INC.
Active
Other names
Ham Lake Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY LYNNE ROCKSTAD (DIRECTOR OF OPERATIONS)
(763) 269-8052
Entity
Organization
Contact information
Practice address
16210 ABERDEEN ST NE, HAM LAKE, MN 55304-5410
(763) 413-0880
(763) 413-0850
Mailing address
139 MAIN STREET, P. O. BOX 136, BETHEL, MN 55005
(763) 269-8051
(763) 269-8053
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04T13NE
BLUE CROSS
MN
05
—
633017700
—
MN
01
—
6409001
MEDICA
MN
Enumeration date
07/17/2006
Last updated
02/20/2015
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