Organization
CENTER FOR SPORTS MEDICINE AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LEIGH SELSETH (CERTIFIED ATHLETIC TRAINER)
(507) 646-8800
Entity
Organization
Contact information
Practice address
1381 JEFFERSON RD, NORTHFIELD, MN 55057-3080
(507) 646-8800
Mailing address
1381 JEFFERSON RD, NORTHFIELD, MN 55057-3080
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
1791
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1791
STATE REGISTRATION NUMBER
MN
Enumeration date
01/08/2007
Last updated
08/22/2020
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