Provider Demographics
NPI:1700773371
Name:ROSENDAHL, MCKINSEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:MCKINSEY
Middle Name:
Last Name:ROSENDAHL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 8TH ST NW
Mailing Address - Street 2:
Mailing Address - City:FOSSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56542-1010
Mailing Address - Country:US
Mailing Address - Phone:218-431-1241
Mailing Address - Fax:
Practice Address - Street 1:2080 36TH AVE SW STE 110
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7597
Practice Address - Country:US
Practice Address - Phone:218-431-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist