Provider Demographics
NPI:1326495011
Name:ISBELL, JAMES ROBERT (PTA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:ISBELL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ROBERT
Other - Last Name:ISBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:800 BOONE AVE N
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4468
Mailing Address - Country:US
Mailing Address - Phone:763-417-8888
Mailing Address - Fax:763-417-9999
Practice Address - Street 1:800 BOONE AVE N
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4468
Practice Address - Country:US
Practice Address - Phone:763-417-8888
Practice Address - Fax:763-417-9999
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA828225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant