Individual
KIM J ROSENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1511 HIGHWAY 59 S, SUITE A, THIEF RIVER FALLS, MN 56701-3413
(218) 681-0449
(218) 681-0490
Mailing address
1560 S CAROL ST, MERIDIAN, ID 83646-1839
(208) 287-9420
(208) 287-9426
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H400133424
MEDICARE PROVIDER #
MN
01
—
P01328766
RAILROAD MEDICARE
MN
Enumeration date
07/06/2006
Last updated
03/22/2016
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