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MINNESOTA MEDICAL AND REHABILITATIVE SERVICES, LLC

Deactivated Organization

MINNESOTA MEDICAL AND REHABILITATIVE SERVICES, LLC is a Physical Therapy Assistant organization located in ST. LOUIS PARK, Minnesota. NPI 1154302545 is deactivated in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · ST. LOUIS PARK, MN

This NPI has been deactivated. The record was deactivated on March 29, 2022. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1154302545
Provider Type
Organization
NPI Issued
Nov 11, 2005 (16.378082191781 yrs)
Last Updated
Sep 18, 2025
Deactivated
Mar 29, 2022
Licenses
5169 (MN)
102980 (MN)
2264 (MN)
6034 (MN)
5806 (MN)

Practice Information

Address
4201 EXCELSIOR BLVD
ST. LOUIS PARK, MN, 554164728
Browse MN providers · Browse ZIP 55416
Phone
9525643880
Fax
9529459536
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Occupational Therapist
Additional Specialty
Physical Therapy Assistant
Additional Specialty
Physical Therapy Assistant
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.