Thomas Letrud II, PTA

Individual provider Active NPI Physical Therapy Assistant · Ortonville, MN

NPI 1801305495 · NPPES record last updated Sep 26, 2017

Key facts

NPI
1801305495
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0271 (SD)
Practice address
10 4TH St SE
Ortonville, MN 56278
Phone
(320) 305-1311
NPI assigned
Sep 26, 2017
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

LicenseStateTypeSpecialty
0271SDMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0271 SD Yes

Addresses

Primary practice location

10 4TH St SE
Ortonville, MN 56278

Mailing address

10 4TH St SE
Ortonville, MN 56278-1532

Other providers in Ortonville, MN

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

Sources for this page

Verify at the official NPI Registry.