Provider Demographics
NPI:1619991502
Name:YURICK, ANTHONY C (PT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:C
Last Name:YURICK
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 1:3833 COON RAPIDS BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2697
Mailing Address - Country:US
Mailing Address - Phone:763-427-8320
Mailing Address - Fax:763-712-5429
Practice Address - Street 1:3833 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2697
Practice Address - Country:US
Practice Address - Phone:763-427-8320
Practice Address - Fax:763-712-5429
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN790516OtherAMERICA'S PPO
MN55D53YUOtherBCBS OF MN
MN6411546OtherMEDICA
MN962871010735OtherPREFERRED ONE
MNHP44365OtherHEALTHPARTNERS