Provider Demographics
NPI:1255387593
Name:STEFFEN, MICHELLE M (MPT)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
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Mailing Address - Street 1:1543 E RIVER TER
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3647
Mailing Address - Country:US
Mailing Address - Phone:608-213-8327
Mailing Address - Fax:612-339-9843
Practice Address - Street 1:701 25TH AVE S
Practice Address - Street 2:SUITE 304
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1513
Practice Address - Country:US
Practice Address - Phone:612-339-2353
Practice Address - Fax:612-339-9843
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN7091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN61-06104OtherMEDICA
MN602K8STOtherBLUE CROSS