Provider Demographics
NPI:1093136038
Name:NORTH STAR PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:NORTH STAR PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-455-3292
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:DUBOIS
Mailing Address - State:WY
Mailing Address - Zip Code:82513-0775
Mailing Address - Country:US
Mailing Address - Phone:307-455-3292
Mailing Address - Fax:307-455-3339
Practice Address - Street 1:1403 W. RAMSHORN
Practice Address - Street 2:
Practice Address - City:DUBOIS
Practice Address - State:WY
Practice Address - Zip Code:82513
Practice Address - Country:US
Practice Address - Phone:307-455-3292
Practice Address - Fax:307-455-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT0747261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy