Provider Demographics
NPI:1699839399
Name:FINKE, PETER W (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:W
Last Name:FINKE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 JEFFERSON ST N
Mailing Address - Street 2:TRI COUNTY HOSPITAL
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1308
Mailing Address - Country:US
Mailing Address - Phone:218-631-7495
Mailing Address - Fax:218-631-7511
Practice Address - Street 1:311JEFFERSON ST. NORTH
Practice Address - Street 2:TRI COUNTY HOSPTIAL
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482
Practice Address - Country:US
Practice Address - Phone:218-631-7495
Practice Address - Fax:218-631-7511
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
650001074Medicare ID - Type Unspecified