Provider Demographics
NPI:1679705891
Name:WEST, MARGARET A (PTA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:WEST
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806-2306
Mailing Address - Country:US
Mailing Address - Phone:218-733-9596
Mailing Address - Fax:479-657-6607
Practice Address - Street 1:200 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-1518
Practice Address - Country:US
Practice Address - Phone:218-732-0868
Practice Address - Fax:218-732-8502
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA502225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN683227000Medicaid
MN683227000Medicaid