Organization
REGIONS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY PORTER (PHYSICAL THERAPIST ASSISTANT)
(651) 254-7711
Entity
Organization
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 254-7700
(651) 254-7710
Mailing address
6823 BLACK DUCK CIR, LINO LAKES, MN 55014-1321
(651) 235-2070
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1039
MN
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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