IndividualActive
Ian Provence, DPT
NPI 1225849870 · Orthopedic Physical Therapist · Coon Rapids, MN
Provider details
- NPI number
- 1225849870
- Entity type
- Individual
- Primary specialty
- Orthopedic Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
9055 Springbrook Dr Nw
Coon Rapids, MN 55433-5841
Phone: (763) 228-2781
Approximate (ZIP-level) locationGet directions
Mailing address
7226 58th Ave N
Minneapolis, MN 55428-3222
Registry dates
- Enumerated
- 2025-01-14
- Last updated
- 2025-01-14
- Certified
- 2025-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.