Provider Demographics
NPI:1881230704
Name:PHYSICIANS' DIAGNOSTICS & REHABILITATION,LTD
Entity Type:Organization
Organization Name:PHYSICIANS' DIAGNOSTICS & REHABILITATION,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:GINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-908-2700
Mailing Address - Street 1:7700 FRANCE AVE S STE 240
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5878
Mailing Address - Country:US
Mailing Address - Phone:952-908-2700
Mailing Address - Fax:952-908-2701
Practice Address - Street 1:7700 FRANCE AVE S STE 240
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5878
Practice Address - Country:US
Practice Address - Phone:952-908-2700
Practice Address - Fax:952-908-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty