Provider Demographics
NPI:1497741847
Name:VAN ORMAN, TROY A (PT)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:A
Last Name:VAN ORMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 ROWE AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-9700
Mailing Address - Country:US
Mailing Address - Phone:507-372-2232
Mailing Address - Fax:507-372-7326
Practice Address - Street 1:1530 ROWE AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-9700
Practice Address - Country:US
Practice Address - Phone:507-372-2232
Practice Address - Fax:507-372-7326
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5980225100000X
SD0742225100000X
IA03343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4998547OtherBLUE CROSS BLUE SHIELD SD
MN596867OtherARAZ
MN64-05337OtherMEDICA
MN64-03578OtherMEDICA
MN0742OtherDAKOTACARE
MN64-04220OtherMEDICA
SD8B716VAOtherBLUE CROSS BLUE SHIELD MN
MN5027OtherAVERA HEALTH PLANS
SD64-11295OtherMEDICA
MN64-03860OtherMEDICA
MN64-11294OtherMEDICA
SD0742OtherDAKOTACARE
MN21095OtherSIOUX VALLEY HEALTH PLANS
SD64-11483OtherMEDICA
MN8B837VAOtherBLUE CROSS BLUE SHEILD MN