Provider Demographics
NPI:1114471141
Name:NASH, BYRAM (DPT)
Entity Type:Individual
Prefix:
First Name:BYRAM
Middle Name:
Last Name:NASH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 19TH ST NW STE 203
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2951
Mailing Address - Country:US
Mailing Address - Phone:507-752-4325
Mailing Address - Fax:
Practice Address - Street 1:3270 19TH ST NW STE 203
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2951
Practice Address - Country:US
Practice Address - Phone:507-752-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist