Provider Demographics
NPI:1659601508
Name:CHURCHILL, STEVEN PATRICK (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PATRICK
Last Name:CHURCHILL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4200 DAHLBERG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4840
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5651
Practice Address - Street 1:8290 UNIVERSITY AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-1847
Practice Address - Country:US
Practice Address - Phone:763-786-9543
Practice Address - Fax:763-786-3320
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2016-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN8701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist