Basic Information
| Provider Information | |||||||||
| NPI: | 1053409383 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OYS | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | KATHLEEN | ||||||||
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| Credential: | P.T. , DPT | ||||||||
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| OtherLastName: | OYS | ||||||||
| OtherFirstName: | PATRICIA | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8170 33RD AVE S # MS 21110Q | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554254516 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 LAKE DR E | ||||||||
| Address2: | |||||||||
| City: | CHANHASSEN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553179302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529934300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 03/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2878 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.