Provider Demographics
NPI:1609656552
Name:STEIN, ABIGAIL MICHAELA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:MICHAELA
Last Name:STEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:MICHAELA
Other - Last Name:DETTMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15675 DARLING PATH
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4604
Mailing Address - Country:US
Mailing Address - Phone:651-253-9525
Mailing Address - Fax:
Practice Address - Street 1:1381 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3080
Practice Address - Country:US
Practice Address - Phone:507-646-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist