Organization
ACHIEVE THERAPY LLC
Active
Other names
Achieve Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE D ELLIS ATC PTA (OWNER OFFICE MANAGER)
(701) 746-8374
Entity
Organization
Contact information
Practice address
829 LAKE AVE, DETROIT LAKES, MN 56501-3017
(218) 844-5340
Mailing address
PO BOX 12938, 1425 S COLUMBIA RD, GRAND FORKS, ND 58208-2938
(701) 746-8374
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183H5SE
BCBS MN
MN
Enumeration date
03/04/2008
Last updated
10/15/2018
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