Provider Demographics
NPI:1376202077
Name:RAUEN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:RAUEN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON-RAUEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:507-299-0017
Mailing Address - Street 1:1200 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:ZUMBROTA
Mailing Address - State:MN
Mailing Address - Zip Code:55992-1152
Mailing Address - Country:US
Mailing Address - Phone:507-358-3289
Mailing Address - Fax:
Practice Address - Street 1:309 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ZUMBROTA
Practice Address - State:MN
Practice Address - Zip Code:55992-5599
Practice Address - Country:US
Practice Address - Phone:507-299-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1396722674OtherPROVIDER NPI