Garrett Estenson, PT, DPT, MBA

Individual provider Active NPI Physical Therapist · Mora, MN

NPI 1215008263 · NPPES record last updated Feb 3, 2017

Key facts

NPI
1215008263
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7516 (MN)
Practice address
301 Highway 65 S
Mora, MN 55051-1899
Phone
(320) 225-3356
Fax
(320) 225-3370
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
7516MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pokegama Physical Therapy, LLC Physical Therapist Past Accepting new patients
Pokegama Physical Therapy Consultants, LLC Physical Therapist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gestenson202308@excellian.direct.allina.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7516 MN Yes

Addresses

Primary practice location

301 Highway 65 S
Mora, MN 55051-1899

Mailing address

301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 225-3356

Other providers in Mora, MN

All providers in Mora, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.