Bradie Lynn Nelk

Individual provider Active NPI Physical Therapist · Wheaton, MN

NPI 1811323611 · NPPES record last updated Sep 25, 2013

Key facts

NPI
1811323611
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
9494 (MN)
Practice address
1205 5TH Ave N
Wheaton, MN 56296-4500
Phone
(320) 563-8269
Fax
(320) 563-8175
NPI assigned
Sep 25, 2013
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)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Big Stone Therapies, Inc Physical Therapist Past
since Mar 10, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9494 MN Yes

Addresses

Primary practice location

1205 5TH Ave N
Wheaton, MN 56296-4500

Mailing address

309 Washington Ave
Ortonville, MN 56278-1357
Phone (320) 839-4271

Other providers in Wheaton, MN

All providers in Wheaton, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.