Provider Demographics
NPI:1013004472
Name:COAPSTICK, KAY (LPT)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:COAPSTICK
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3440
Mailing Address - Country:US
Mailing Address - Phone:320-631-2200
Mailing Address - Fax:320-632-3728
Practice Address - Street 1:1108 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3440
Practice Address - Country:US
Practice Address - Phone:320-631-2200
Practice Address - Fax:320-632-3728
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP45712OtherHEALTH PARTNERS
MN21D61COOtherBLUE CROSS BLUE SHIELD
MN6401242OtherMEDICA
MN616055700Medicaid
MN6401242OtherMEDICA