Provider Demographics
NPI:1821765306
Name:CORTEX REHABILITATION LLC
Entity Type:Organization
Organization Name:CORTEX REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DUEFFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-380-1237
Mailing Address - Street 1:6620 MEADOWLARK LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-6043
Mailing Address - Country:US
Mailing Address - Phone:605-380-1237
Mailing Address - Fax:
Practice Address - Street 1:11658 FOUNTAINS DR
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7195
Practice Address - Country:US
Practice Address - Phone:612-284-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty