Provider Demographics
NPI:1881237998
Name:BRIDGES, SHARON M (PT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 COUNTY ROAD 14 NE
Mailing Address - Street 2:
Mailing Address - City:MILTONA
Mailing Address - State:MN
Mailing Address - Zip Code:56354-8150
Mailing Address - Country:US
Mailing Address - Phone:320-808-5515
Mailing Address - Fax:
Practice Address - Street 1:755 COUNTY ROAD 14 NE
Practice Address - Street 2:
Practice Address - City:MILTONA
Practice Address - State:MN
Practice Address - Zip Code:56354-8150
Practice Address - Country:US
Practice Address - Phone:320-808-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist