Lee Myrdal

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2317 Issued in MN

Practice address

275 Penn Ave N
Minneapolis, MN 55405-1216

Phone

(612) 377-4723

NPI assigned

Jan 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1366156234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARQUETTE AVE APT 1212",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012029",
            "telephone_number": "218-341-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051216",
            "telephone_number": "612-377-4723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "471 Lynnhurst Ave W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043408",
            "country_code": "US",
            "telephone_number": "651-645-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYRDAL",
        "first_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Myhran
• Alicia Myhre, D.O.
• Ashley Myhre, LAMFT
• Danny Myhre, LADC
• Marci Marie Mylan, PHD
• Lori Kay Myren-Manbeck, PHD, LP
• Anna Erika Isabel Myrgren
• Myride LLC
• Carol Ruth Myslivecek, CRNA
• Mytherapymn LLC

• Physical Therapy Assistant in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.