Dane Allen Anderson, PTA
Individual provider Active NPI Physical Therapy Assistant · Burnsville, MN
NPI 1275820243 · NPPES record last updated Jun 29, 2011
Key facts
- NPI
- 1275820243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A1452 (MN)
- Practice address
- 100 Cobblestone LN
Burnsville, MN 55337-4578 - Phone
- (763) 520-0409
- NPI assigned
- Jun 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1452 | MN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A1452 | MN | Yes |
Addresses
Primary practice location
100 Cobblestone LN
Burnsville, MN 55337-4578
Mailing address
766 Idaho Ave E
Saint Paul, MN 55106-1049
Phone (612) 597-6994
Other providers in Burnsville, MN
- Carole M Andersen
- Alyssa Anderson
- Andrew Joseph Anderson
- Brianna Anderson
- Chara J Anderson
- Emily Anderson
- Jennifer Lynne Anderson
- Julie R. Anderson
- Karen Lynn Anderson
- Kristin Joy Anderson
All providers in Burnsville, MN · Physical Therapy Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.