Provider Demographics
NPI:1184611899
Name:FOLEY PHYSICAL REHAB INC.
Entity type:Organization
Organization Name:FOLEY PHYSICAL REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:MILEJCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:320-968-4677
Mailing Address - Street 1:400 BROADWAY AVE N
Mailing Address - Street 2:PO BOX 416
Mailing Address - City:FOLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56329-8794
Mailing Address - Country:US
Mailing Address - Phone:320-968-4677
Mailing Address - Fax:320-968-7909
Practice Address - Street 1:400 BROADWAY AVE N
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:MN
Practice Address - Zip Code:56329-8794
Practice Address - Country:US
Practice Address - Phone:320-968-4677
Practice Address - Fax:320-968-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN169330OtherUCARE
MN7312142OtherAETNA
MN84508OtherHEALTH PARTNERS
MN065M7FOOtherBCBS
MN1031097OtherPREFERRED ONE