Provider Demographics
NPI:1962014878
Name:MARGOTTA, KAYLEN ANNE (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLEN
Middle Name:ANNE
Last Name:MARGOTTA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYLEN
Other - Middle Name:ANNE
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0002
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:3100 19TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6606
Practice Address - Country:US
Practice Address - Phone:507-322-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist