| Doctor Name: | MR. TIMOTHY S SLY |
| NPI Number: | 1245431055 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 4522 |
| Business Practice Address: | 415 Jefferson St N Wadena, MN - 564821264 |
| Business Phone Number: | 2186317475 |
| Business Fax Number: | 2186328765 |
| Mailing Address: | 15642 Shady Acres Dr, WADENA |
| State: | MN |
| Postal Code: | 564823018 |
| Phone Number: | 2186312025 |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4522 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |