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Organization

PRESCOTT THERAPIES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRAVIS JOHN KIERSTEAD PT (MANAGING MEMBER)
(952) 807-7312
Entity
Organization

Contact information

Practice address
825 NICOLLET MALL STE 1947, MINNEAPOLIS, MN 55402-2707
(952) 200-0215
(833) 499-1896
Mailing address
18872 42ND AVE N, PLYMOUTH, MN 55446-3068
(952) 807-7312

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
12/12/2020
Last updated
11/20/2024
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