Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
Y | 225100000X | Physical Therapist | 2070 | MN |
NPI | 1902971278 |
---|---|
Provider Name | Steven Robert Carr |
First Address | Saint Cloud, MN 56301-9668 |
Second Address | Saint Cloud, MN 56301-9668 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 05/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264M1NO | BLUE CROSS BLUE SHIELD OF MN (01) | MN |
584224700 | (05) | MN |
6402742 | MEDICA (01) | MN |
6402742 | SELECT CARE (01) | MN |
7B068CA | BLUE CROSS BLUE SHIELD (01) | MN |
HP43510 | HEALTHPARTNERS (01) | MN |