| Danielle Prom, DPT | |
|
701 Horizon Cir, Cloquet, MN 55720-3051 | |
| (218) 879-6956 | |
| Not Available |
| Full Name | Danielle Prom |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 701 Horizon Cir, Cloquet, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306369319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 9184 (Minnesota) | Primary |
| Provider Name | Odom Sports Medicine Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1275557886 PECOS PAC ID: 0143485607 Enrollment ID: O20131004000063 |
| Mailing Address | Practice Location Address |
|---|---|
| Danielle Prom, DPT 10653 Wayzata Blvd Ste 200, Minnetonka, MN 55305-1543 Ph: (952) 224-1919 | Danielle Prom, DPT 701 Horizon Cir, Cloquet, MN 55720-3051 Ph: (218) 879-6956 |
Karen Marie Johnson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1204 Cloquet Ave, Cloquet, MN 55720 Phone: 218-878-0805 Fax: 218-878-0794 | |
Joseph Urban Quade, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1204 Cloquet Ave, Cloquet, MN 55720 Phone: 218-878-0805 Fax: 218-878-0794 | |
Stephanie Ann Elling, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1204 Cloquet Ave, Cloquet, MN 55720 Phone: 218-878-0805 Fax: 218-878-0794 | |
Amanda Marie Dornhecker, DPT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 927 Trettel Ln, Cloquet, MN 55720 Phone: 218-879-1227 | |
Kathryn Dorothy Roufs, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1204 Cloquet Ave, Cloquet, MN 55720 Phone: 218-878-0805 | |
Kelly Lynn Burgner, DPT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 1204 Cloquet Ave, Cloquet, MN 55720 Phone: 218-878-0805 |