| Tia Hagy, PT, DPT | |
|
35 State Ave, Faribault, MN 55021-6368 | |
| (507) 497-3790 | |
| Not Available |
| Full Name | Tia Hagy |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 35 State Ave, Faribault, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235867466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 12808 (Minnesota) | Primary |
| Provider Name | Park Nicollet Clinic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Provider Name | Tria Orthopaedic Center Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1518273085 PECOS PAC ID: 3173570561 Enrollment ID: O20110310000999 |
| Mailing Address | Practice Location Address |
|---|---|
| Tia Hagy, PT, DPT 10 Division St W Apt 320, Faribault, MN 55021-6067 Ph: (563) 260-8427 | Tia Hagy, PT, DPT 35 State Ave, Faribault, MN 55021-6368 Ph: (507) 497-3790 |
Sarah Ann Jentink, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 35 State Ave, Faribault, MN 55021 Phone: 507-332-4790 | |
Dr. Liana Blomgren, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1961 Cardinal Ln Ste A, Faribault, MN 55021 Phone: 507-333-2986 Fax: 507-333-2918 | |
Maria Bohl, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1961 Cardinal Ln Ste A, Faribault, MN 55021 Phone: 507-333-2986 Fax: 507-333-2918 | |
Mrs. Amy Renee Willingham, PHYSICALTHERAPISTMPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1620 17th St Nw, Faribault, MN 55021 Phone: 507-332-2204 Fax: 507-332-2270 | |
Jason Niemann, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1961 Cardinal Ln Ste A, Faribault, MN 55021 Phone: 507-333-2986 | |
Nathan A Moldestad, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 200 8th Ave Nw, Suite 4, Faribault, MN 55021 Phone: 507-334-5627 Fax: 507-334-1824 | |
Kelly Kitzman, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1520 17th St Nw, Faribault, MN 55021 Phone: 218-205-0190 |