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Organization

ORTHOPEDIC & SPORTS PHYSICAL THERAPY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHAWN MARIE KRAUSE ROBERTS PT/ATC (PRESIDENT)
(218) 641-7725
Entity
Organization

Contact information

Practice address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725
(218) 641-6625
Mailing address
430 5TH ST N, BRECKENRIDGE, MN 56520-1426
(218) 641-7725
(218) 641-6625

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1180
ND
225100000X
Physical Therapist
6521
MN
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057K80R
MN BCBS
MN
01
101592300
US DEPT OF LABOR
MN
01
1041486
PREFERRED ONE
MN
01
121G4OR
MN BCBS FOR OT'S
MN
05
1458152
ND
05
148478000
MN
01
96570
HEALTH PARTNERS
MN
01
DD3739
RR MEDICARE
MN
Enumeration date
06/24/2006
Last updated
01/10/2018
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