Individual
MRS. REBECCA JOYCE WIERSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2400 W 64TH ST, RICHFIELD, MN 55423-1001
(612) 798-8339
Mailing address
7909 ISLETON AVE S, COTTAGE GROVE, MN 55016-2149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
7373
MN
2251P0200X
Pediatric Physical Therapist
Primary
7373
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311P6BE
BLUE CROSS MN
MN
Enumeration date
10/13/2006
Last updated
09/11/2025
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