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Individual

DR. BRIAN JAMES THEISEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, ATC

Contact information

Practice address
8100 NORTHLAND DR, MINNEAPOLIS, MN 55431-4800
(952) 831-8742
Mailing address
8100 NORTHLAND DR, MINNEAPOLIS, MN 55431-4800
(952) 831-8742

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10441
MN
2255A2300X
Athletic Trainer
2344
MN

Other

Enumeration date
05/02/2012
Last updated
08/23/2016
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