Provider Demographics
NPI:1609837798
Name:PRESTHOLDT, KARI LYNN (MPT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:PRESTHOLDT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4227 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-2008
Mailing Address - Country:US
Mailing Address - Phone:612-201-7888
Mailing Address - Fax:
Practice Address - Street 1:6515 BARRIE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2305
Practice Address - Country:US
Practice Address - Phone:952-922-5019
Practice Address - Fax:952-922-1384
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist