Provider Demographics
NPI:1700835527
Name:ARNESON, MICHAEL TODD (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:ARNESON
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 1:309 1ST ST NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-4635
Mailing Address - Country:US
Mailing Address - Phone:320-631-2302
Mailing Address - Fax:320-631-2303
Practice Address - Street 1:309 1ST ST NE
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-4635
Practice Address - Country:US
Practice Address - Phone:320-631-2302
Practice Address - Fax:320-631-2303
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64522251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN123784OtherUCARE INDIVIDUAL PROVIDER NUMBER
MN186943OtherUCARE GROUP PROVIDER NUMBER
MN650002050OtherMEDICARE PTAN NUMBER
MN001620900MNMedicaid
MN0U836ADOtherBC/BS GROUP PROVIDER NUMBER
MN0U837AROtherBC/BS INDIVIDUAL PROVIDER NUMBER
MN001620900MNMedicaid