Provider Demographics
NPI:1609214782
Name:GRESS, ELISABETH PERRY (PT)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:PERRY
Last Name:GRESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ELISABETH
Other - Middle Name:PERRY
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2800 CHICAGO AVE. SOUTH
Mailing Address - Street 2:SUITE #102
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407
Mailing Address - Country:US
Mailing Address - Phone:612-863-4446
Mailing Address - Fax:
Practice Address - Street 1:2800 CHICAGO AVE. SOUTH
Practice Address - Street 2:SUITE #102
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407
Practice Address - Country:US
Practice Address - Phone:612-863-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist