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

Stacey Lyke, PTA

Individual provider Physical Therapy Assistant · NPI 1679288062

Stacey Lyke, PTA is a Physical Therapy Assistant in Grand Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2023.

Licensed in
MN
In the registry since
2023
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

923 Hale Lake Pt
Grand Rapids, MN 55744-9615
Phone: (218) 326-0543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence A2580 (MN)

Record details

NPI number1679288062
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJanuary 19, 2023
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 19, 2023
Mailing address5786 Martima Rd, Floodwood, MN 55736-8124

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