Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Primary Care and Rehabilitation, PA

Organization Rehabilitation Practitioner · NPI 1780963355

Center for Primary Care and Rehabilitation, PA is a Rehabilitation Practitioner in Eagan, Minnesota. Licensed in Minnesota. Registered with an NPI since 2011.

Licensed in
MN
In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

880 Blue Gentian Rd Ste 165
Eagan, MN 55121-1772
Phone: (651) 789-8022
Fax: (651) 789-8028
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X · Licence 45600 (MN)

Record details

NPI number1780963355
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elena Polukhin — Owner/Medical Director · (651) 789-8022
NPI enumeratedAugust 12, 2011
Last updated in NPPESAugust 12, 2011
Mailing address3006 Frank St, Maplewood, MN 55109-5501

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