BST Marshall LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BST MARSHALL LLC

Practice address

1420 E College Dr
Suite 704
Marshall, MN 56258-2075

Phone

(507) 532-3393

Fax

(320) 839-4196

NPI assigned

Dec 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wade D Vandover, PT

Title

President

Phone

(320) 839-4152

Specialties & licenses 5

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1104987494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 ROY STREET",
            "address_2": "BST MARSHALL LLC",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781138",
            "telephone_number": "320-839-4271",
            "fax_number": "320-839-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E COLLEGE DR",
            "address_2": "SUITE 704",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582075",
            "telephone_number": "507-532-3393",
            "fax_number": "320-839-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BST MARSHALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "VANDOVER",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-839-4152",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruns Chiropractic, Inc
• Dean Ervin Bruns, D.C.
• Troy Charles Bruns, D.N.P
• Kelly Jean Ritter Brunsvold, MS,CCC-SLP
• Heather Bruse, LADC
• Nathan James Burns, ATC
• Kelsey Buysse, OT
• Trent Patrick Carlson, M.D.
• Braden Carmody, MS, RD, LN
• CCM Health

• All providers in Marshall, MN
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.