Provider Demographics
NPI:1437559374
Name:GLATT, PAUL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:GLATT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:PAULIE
Other - Middle Name:
Other - Last Name:GLATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:15000 MINNETONKA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-1506
Mailing Address - Country:US
Mailing Address - Phone:952-935-4037
Mailing Address - Fax:952-908-0361
Practice Address - Street 1:15000 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-1506
Practice Address - Country:US
Practice Address - Phone:952-935-4037
Practice Address - Fax:952-908-0361
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist