Paul Rudebusch

Individual provider Active NPI Physical Therapist · Ortonville, MN

NPI 1003043795 · NPPES record last updated Jun 19, 2009

Key facts

NPI
1003043795
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2542 (MN)
Practice address
820 Roy St
Ortonville, MN 56278-1138
Phone
(320) 839-4271
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2542 MN Yes

Addresses

Primary practice location

820 Roy St
Ortonville, MN 56278-1138

Mailing address

410 30TH St NW
#101
Willmar, MN 56201-2346

Other providers in Ortonville, MN

All providers in Ortonville, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.