Peter Richard Stanley, DPT
Individual provider Active NPI Physical Therapist · Le Center, MN
NPI 1992295083 · NPPES record last updated May 14, 2018
Key facts
- NPI
- 1992295083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11070 (MN)
- Practice address
- 444 N Cordova Ave
Le Center, MN 56057-1704 - Phone
- (507) 357-3375
- NPI assigned
- May 14, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11070 | MN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11070 | MN | Yes |
Addresses
Primary practice location
444 N Cordova Ave
Le Center, MN 56057-1704
Mailing address
4301 Park Glen Rd Apt 230
Minneapolis, MN 55416-4786
Phone (763) 843-6664
Other providers in Le Center, MN
- George Michael Riviere
- Dale Gregory Schmoll
- Jessica Marie Shouler
- Soaring Health Acupuncture LLC
- St Peter Eyecare Center, Inc
- Sunhaven, Inc.
- The Beacon at Le Center LLC
- Mark S Traxler
- Jennifer Weiers
- Kayla Wolff
All providers in Le Center, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2018. 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.