| Organization Name: | FILLMORE COUNTY PHYSICAL THERAPY SERVICES, INC |
| NPI Number: | 1619249133 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA STENSRUD (OWNER) |
| Mailing Address: | 212 Fillmore St W Preston |
| State: | MN US |
| Postal Code: | 559651226 |
| Phone Number: | 5078678007 |
| Fax Number: | 5078678018 |
| NPI Enumeration Date: | 01/30/2012 |
| NPI Last Update Date: | 08/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 8021 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |