Provider Demographics
NPI:1700241825
Name:EMPSON, NICHOLAS A (DPT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:A
Last Name:EMPSON
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 1:8170 33RD AVE
Mailing Address - Street 2:MS: 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-851-8200
Mailing Address - Fax:952-851-8219
Practice Address - Street 1:3601 MINNESOTA DRIVE
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5248
Practice Address - Country:US
Practice Address - Phone:952-851-8200
Practice Address - Fax:952-851-8219
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31019225100000X
MN10231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist