Tyra J Cerny, PTA

Individual provider Active NPI Physical Therapy Assistant · Woodbury, MN

NPI 1740438142 · NPPES record last updated Aug 28, 2008

Key facts

NPI
1740438142
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A365 (MN)
Practice address
8320 City Centre Dr
Suite G
Woodbury, MN 55125-3382
Phone
(651) 738-9888
Fax
(651) 738-9889
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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)
No

State licenses

LicenseStateTypeSpecialty
A365MNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Achievement Center Inc. Physical Therapy Assistant Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A365 MN Yes

Addresses

Primary practice location

8320 City Centre Dr
Suite G
Woodbury, MN 55125-3382

Mailing address

8320 City Centre Dr
Suite G
Woodbury, MN 55125-3382
Phone (651) 738-9888

Other providers in Woodbury, MN

All providers in Woodbury, MN · Physical Therapy Assistant in Minnesota

Sources for this page

Verify at the official NPI Registry.