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Organization

ORTHOPEDIC & SPORTS REHABILIATION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUSTY WALLMAN (OWNER)
(952) 448-9081
Entity
Organization

Contact information

Practice address
7872 CENTURY BLVD, CHANHASSEN, MN 55317-8005
(952) 448-9081
(952) 448-9088
Mailing address
7872 CENTURY BLVD, CHANHASSEN, MN 55317-8005
(952) 448-9081
(952) 448-9088

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6935
MN

Other

Enumeration date
05/16/2007
Last updated
08/22/2020
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