Provider Demographics
NPI:1871673780
Name:BJORK, BETH JOYCE (PT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:JOYCE
Last Name:BJORK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:JOYCE
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:COURAGE CENTER
Mailing Address - Street 2:3915 GOLDEN VALLEY ROAD
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4298
Mailing Address - Country:US
Mailing Address - Phone:763-588-0811
Mailing Address - Fax:763-520-0355
Practice Address - Street 1:COURAGE CENTER
Practice Address - Street 2:3915 GOLDEN VALLEY ROAD
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4298
Practice Address - Country:US
Practice Address - Phone:763-588-0811
Practice Address - Fax:763-520-0355
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6401887OtherMEDICA
MN42F39BJOtherBCBS MINNESOTA
MNHP43205OtherHEALTH PARTNERS