Provider Demographics
NPI:1639738982
Name:LINK PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:LINK PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:651-321-1234
Mailing Address - Street 1:8599 W POINT DOUGLAS RD S STE 200
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-2165
Mailing Address - Country:US
Mailing Address - Phone:651-321-1234
Mailing Address - Fax:651-321-4321
Practice Address - Street 1:8599 W POINT DOUGLAS RD S STE 200
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-2165
Practice Address - Country:US
Practice Address - Phone:651-321-1234
Practice Address - Fax:651-321-4321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty