Provider Demographics
NPI:1861531659
Name:ZETTERLUND, ALLEN (PT)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:ZETTERLUND
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 STEARNS WAY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4491
Mailing Address - Country:US
Mailing Address - Phone:320-229-1500
Mailing Address - Fax:320-229-1505
Practice Address - Street 1:2025 STEARNS WAY
Practice Address - Street 2:SUITE 114
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4491
Practice Address - Country:US
Practice Address - Phone:320-229-1500
Practice Address - Fax:320-229-1505
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist