Organization
PRIME REHABILITATION LLC
Active
Other names
ACCUA Advanced Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LEONARD KALLBERG PT (PRESIDENT)
(952) 412-6207
Entity
Organization
Contact information
Practice address
8690 EAGLE CREEK PKWY, SAVAGE, MN 55378-1284
(952) 412-6207
(952) 487-2829
Mailing address
8690 EAGLE CREEK PKWY, SAVAGE, MN 55378-1284
(952) 412-6207
(952) 487-2829
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160D2KA
BLUECROSS BLUESHIELD OF MINNESOTA
—
05
—
600088600
—
MN
Enumeration date
07/25/2007
Last updated
05/22/2008
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