Provider Demographics
NPI:1003643818
Name:STELTER, ANDREW (DPT)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:STELTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47664 180TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-5255
Mailing Address - Country:US
Mailing Address - Phone:507-676-4405
Mailing Address - Fax:
Practice Address - Street 1:2155 NIAGARA LN N STE 102
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-4654
Practice Address - Country:US
Practice Address - Phone:952-322-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist