Anderson, Stacia R

Anderson, Stacia R is an individual health care provider with primary practice located at 146 Lake St N , Forest Lake MN 55025-2518. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Anderson, Stacia R can be contacted via phone (651) 464-8502.

Contact Information

Primary practice address
146 Lake St N Forest Lake MN 55025-2518
Phone: (651) 464-8502
Fax: (651) 464-8547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4512 Minnesota

Profile Details

NPI number 1730297300
LBN Legal business name Anderson, Stacia R
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Aug 23rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730297300 NPPES
Minnesota Other 195K5AN BLUECROSS BLUESHIELD
Minnesota Other 6400629 BLUECROSS BLUESHIELD
Minnesota MEDICAID 436322100 BLUECROSS BLUESHIELD
Minnesota Other HP35860 BLUECROSS BLUESHIELD

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