Dan Haack, P.T.

Individual provider Active NPI Physical Therapist · Zimmerman, MN

NPI 1346327384 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346327384
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5021 (MN)
Practice address
25945 Gateway Dr
Zimmerman, MN 55398-5300
Phone
(763) 856-6930
Fax
(763) 856-6933
NPI assigned
Nov 1, 2006
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)
No

State licenses

LicenseStateTypeSpecialty
5021MNMDAudiologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5021 MN Yes

Addresses

Primary practice location

25945 Gateway Dr
Zimmerman, MN 55398-5300

Mailing address

11172 191St Ave NW
Elk River, MN 55330-2803

Other providers in Zimmerman, MN

All providers in Zimmerman, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.