Provider Demographics
NPI:1740820299
Name:THREE IN ONE PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:THREE IN ONE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NIOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:701-934-1119
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:ND
Mailing Address - Zip Code:58533-0204
Mailing Address - Country:US
Mailing Address - Phone:701-934-1119
Mailing Address - Fax:
Practice Address - Street 1:207 MAIN STREET NORTH
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:ND
Practice Address - Zip Code:58533
Practice Address - Country:US
Practice Address - Phone:701-934-1119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty