Provider Demographics
NPI:1659367050
Name:ALBRECHT, MICHELLE L (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:BARTKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1720 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2129
Mailing Address - Country:US
Mailing Address - Phone:605-334-5630
Mailing Address - Fax:605-332-5327
Practice Address - Street 1:1720 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2129
Practice Address - Country:US
Practice Address - Phone:605-334-5630
Practice Address - Fax:605-332-5327
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1024225100000X
MN6453225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1024OtherDAKOTACARE
SD26F64BAOtherBLUE CROSS BLUE SHIELD MN
SD64-01179OtherMEDICA
SD4994833OtherBLUE CROSS BLUE SHIELD SD
SD869314OtherARAZ
SD64-00662OtherMEDICA
SD5832155Medicaid
SD5832150Medicaid
SD4997711OtherBLUE CROSS BLUE SHIELD SD
SD64-05324OtherMEDICA
MN26F65BAOtherBLUE CROSS BLUE SHIELD MN
SD31676OtherSIOUX VALLEY HEALTH PLANS
SD4997712OtherBLUE CROSS BLUE SHIELD SD
SD5832153Medicaid
SD4997710OtherBLUE CROSS BLUE SHIELD SD
SD5832152Medicaid
SD64-04207OtherMEDICA