Organization Name: | GATEWAY PHYSCIAL THERAPY, INC |
NPI Number: | 1386830768 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANE COWLEY (CO-DIRECTOR) |
Mailing Address: | 2601 Centennial Dr Suite 101 North St Paul |
State: | MN US |
Postal Code: | 551093041 |
Phone Number: | 6512244930 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2007 |
NPI Last Update Date: | 09/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |