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

Mary T Outpatient

Organization Physical Therapist · NPI 1396475927

Mary T Outpatient is a Physical Therapist in Coon Rapids, Minnesota. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

11800 Xeon Blvd NW
Coon Rapids, MN 55448-2061
Phone: (763) 489-3638
Fax: (763) 647-3885
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1396475927
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Tjosvold — Chief Administrative Officer · (763) 567-8951
NPI enumeratedJune 15, 2022
Last updated in NPPESJune 24, 2022
Certification dateJune 24, 2022
Mailing address1555 118th Ln Nw Ste 1, Coon Rapids, MN 55448-7500

Other providers in Coon Rapids