| Orthopedic & Spine Therapy Of Albertville, Llc | |
|
5232 Kyler Ave Ne Ste C Albertville MN 55301-4634 | |
| (763) 260-5313 | |
| (833) 599-7671 |
| Full Name | Orthopedic & Spine Therapy Of Albertville, Llc |
|---|---|
| Speciality | Physical Therapist |
| Location | 5232 Kyler Ave Ne Ste C, Albertville, Minnesota |
| Authorized Official Name and Position | Joshua Augustus Cadwallader (OWNER) |
| Authorized Official Contact | 7632605313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthopedic & Spine Therapy Of Albertville, Llc 5232 Kyler Ave Ne Ste C Albertville MN 55301-4775 Ph: (763) 260-5313 | Orthopedic & Spine Therapy Of Albertville, Llc 5232 Kyler Ave Ne Ste C Albertville MN 55301-4634 Ph: (763) 260-5313 |
| NPI Number | 1235674037 |
|---|---|
| Provider Enumeration Date | 01/03/2017 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Medicare PECOS PAC ID | 1850660077 |
|---|---|
| Medicare Enrollment ID | O20170703000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235674037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Joshua A Cadwallader |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710146881 PECOS PAC ID: 0042384232 Enrollment ID: I20180426002763 |
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