Basic Information
| Provider Information | |||||||||
| NPI: | 1366659690 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REXIN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | TRINITY HOSPITALS | ||||||||
| Address2: | 1W BURDICK EXPY | ||||||||
| City: | MINOT | ||||||||
| State: | ND | ||||||||
| PostalCode: | 58701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7018575105 | ||||||||
| FaxNumber: | 7018575646 | ||||||||
| Practice Location | |||||||||
| Address1: | TRINITY HOSPITALS | ||||||||
| Address2: | 1W BURDICK EXPY | ||||||||
| City: | MINOT | ||||||||
| State: | ND | ||||||||
| PostalCode: | 58701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7018575105 | ||||||||
| FaxNumber: | 7018575646 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 06/11/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1157 | ND | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.