Provider Demographics
NPI:1528409802
Name:A STEP AHEAD PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Entity Type:Organization
Organization Name:A STEP AHEAD PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:612-875-2739
Mailing Address - Street 1:15000 VIEWCREST LN
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-5385
Mailing Address - Country:US
Mailing Address - Phone:612-875-2739
Mailing Address - Fax:
Practice Address - Street 1:4401 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2024
Practice Address - Country:US
Practice Address - Phone:612-875-2739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty