Paul Dorn, PTA
Individual provider Active NPI Contractor · Saint James, MN
NPI 1558720987 · NPPES record last updated Feb 12, 2016
Key facts
- NPI
- 1558720987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 73650 345TH St
Saint James, MN 56081-5555 - Phone
- (507) 351-7615
- NPI assigned
- Feb 12, 2016
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
73650 345TH St
Saint James, MN 56081-5555
Mailing address
73650 345TH St
Saint James, MN 56081-5555
Phone (507) 351-7615
Other providers in Saint James, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2016. 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.