Organization
ORTHOREHAB SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK W SIEWERT PT (OWNER)
(612) 339-2041
Entity
Organization
Contact information
Practice address
800 PRAIRIE CENTER DR, SUITE 230, EDEN PRAIRIE, MN 55344-7328
(952) 746-5858
(952) 746-5859
Mailing address
800 PRAIRIE CENTER DR, SUITE 230, EDEN PRAIRIE, MN 55344-7328
(952) 746-5858
(952) 746-5859
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B813OR
BC GROUP PROV #
MN
Enumeration date
06/07/2007
Last updated
08/03/2010
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