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

Mardon Ellen So

Individual provider Physical Therapist · NPI 1063238095

Mardon Ellen So is a Physical Therapist in Private Practice in Grand Marais, Minnesota. Qualified in 2023, 3 years ago. Practices with Multicare Health System, a 2,302-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2024

Practice location Address checks out

515 5th Ave W
Grand Marais, MN 55604-3017
Phone: (218) 387-3040
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13275 (MN)

Record details

NPI number1063238095
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 25, 2024
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address515 5th Ave W, Grand Marais, MN 55604-3017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Multicare Health System — 2302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Grand Marais