Provider Demographics
NPI:1285379297
Name:ERDMANN, SUMMER (DPT)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:ERDMANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30239 122ND ST
Mailing Address - Street 2:
Mailing Address - City:GREY EAGLE
Mailing Address - State:MN
Mailing Address - Zip Code:56336-4783
Mailing Address - Country:US
Mailing Address - Phone:651-398-6957
Mailing Address - Fax:
Practice Address - Street 1:1604 1ST ST S STE 290
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4243
Practice Address - Country:US
Practice Address - Phone:320-235-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist