ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS LLC NPI 1205694742

NPI Information

  • NPI: 1205694742
  • Provider Name: ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS LLC
  • Classification: Physical Therapist - 2251X0800X
  • Specialization: Orthopedic
  • Entity Type: Organization
  • Address: 5200 WILLSON RD STE 150
    EDINA, MN
    ZIP 55424
  • Phone: (952) 232-5020

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NPI Details

ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS LLC is an orthopedic physical therapist in Edina, MN. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS LLC NPI is 1205694742. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5200 WILLSON RD STE 150
EDINA, MN
ZIP 55424-300
Phone: (952) 232-5020

The provider's authorized official is John Bertucci .
The authorized official title is Managing Member/owner and has the following contact phone number (952) 232-5020.

The enumeration date for this NPI number is 3/11/2024 and was last updated on 3/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12251G0304XPhysical TherapistGeriatricsNo
22251S0007XPhysical TherapistSportsNo
32251X0800XPhysical TherapistOrthopedicYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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