Theisen, Staci M

Theisen, Staci M is an sole proprietor health care provider with primary practice located at 158 19Th St S , Sartell MN 56377-2153. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Theisen, Staci M can be contacted via phone (320) 253-5385.

Contact Information

Primary practice address
158 19Th St S Sartell MN 56377-2153
Phone: (320) 253-5385
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 1287 Minnesota

Profile Details

NPI number 1467739367
LBN Legal business name Theisen, Staci M
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2011
Last updated Nov 7th, 2011 - about 13 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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