| Leah Tisdale, | |
|
2450 Riverside Ave, Minneapolis, MN 55454-1450 | |
| (612) 365-6777 | |
| Not Available |
| Full Name | Leah Tisdale |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 2450 Riverside Ave, Minneapolis, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659845071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XP0200X | Occupational Therapist - Pediatrics | 105939 (Minnesota) | Primary |
| Provider Name | Fairview Express Care |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Provider Name | Healtheast Outpatient Services Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1225382526 PECOS PAC ID: 0941447304 Enrollment ID: O20130503000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Leah Tisdale, 2544 Christian Pkwy, Chaska, MN 55318-1986 Ph: (952) 769-6441 | Leah Tisdale, 2450 Riverside Ave, Minneapolis, MN 55454-1450 Ph: (612) 365-6777 |
Taylor Peterson, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 800 E 28th St, Minneapolis, MN 55407 Phone: 612-863-4000 | |
Rachel Esther Hollister, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2450 Riverside Ave, Suite R102, Minneapolis, MN 55454 Phone: 612-273-9400 | |
Ms. Theressa Agnes Burns, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1 Veterans Drive, Minneapolis, MN 55417 Phone: 612-467-3338 Fax: 612-725-2084 | |
Sandra J Stevenson, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 800 E 28th St, Minneapolis, MN 55407 Phone: 612-863-4447 Fax: 612-863-4263 | |
Ellissa A Kurk, PT, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2512 S 7th St, Minneapolis, MN 55454 Phone: 612-273-7100 | |
Heather Christine Hunstad, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1910 5th St Ne, Minneapolis, MN 55418 Phone: 651-341-4055 | |
Danielle Lauren Prince, OTD Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2450 Riverside Ave, Minneapolis, MN 55454 Phone: 612-273-8383 |